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Characteristics of myopic traction maculopathy in myopic Singaporean adults
  1. Saiko Matsumura1,
  2. Charumathi Sabanayagam1,2,3,
  3. Chee Wai Wong1,2,
  4. Chuen-Seng Tan4,
  5. Anthony Kuo2,5,6,
  6. Yee Ling Wong7,
  7. Kyoko Ohno-Matsui8,
  8. Tien Yin Wong1,2,3,9,
  9. Ching-Yu Cheng1,2,3,9,
  10. Quan V Hoang1,2,10,
  11. Seang Mei Saw1,2,3,4
  1. 1 Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
  2. 2 Duke-NUS Medical School, Singapore
  3. 3 Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
  4. 4 Saw Swee Hock School of Public Health, National University of Singapore, Singapore
  5. 5 Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, USA
  6. 6 Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
  7. 7 R&D Vision Sciences, AMERA, Essilor International, Singapore
  8. 8 Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
  9. 9 National University of Singapore, Singapore
  10. 10 Department of Ophthalmology, Harkness Eye Research Institute, Columbia University College of Physicians and Surgeons, New York, New York, USA
  1. Correspondence to Professor Seang Mei Saw, Saw Swee Hock School of Public Health, National University of Singapore, Singapore 169856, Singapore; seang_mei_saw{at}


Purpose To investigate the characteristics, risk factors and visual impact of myopic traction maculopathy (MTM) among adults with myopia in Singapore.

Methods We analysed 3316 myopic eyes of adults aged over 40 years who participated in the Singapore Epidemiology of Eye Diseases-2 study. Detailed questionnaires and ophthalmic examinations were conducted. A total of 2913 myopic eyes of 1639 subjects were graded for MTM by spectral-domain optical coherence tomography. MTM is defined as the presence of retinoschisis, lamellar or full-thickness macula hole and foveal retinal detachment. Fundus photographs were graded for myopic macular degeneration (MMD).

Results Of these 2913 myopic eyes, the mean and SD of age was 60.1±8.0 years; the spherical equivalent (SE) was −2.5±2.3 D; and the axial length (AL) was 24.6±1.3 mm. MTM was found in 0.9% of myopic eyes and 7.3% of highly myopic eyes. In the multivariate analysis, myopic SE (p<0.001), longer AL (p<0.001), MMD (p=0.01) and epiretinal traction (p<0.001) were independent risk factors for MTM. MTM was not associated with age (p=0.38). MTM was significantly associated with poorer best-corrected visual acuity (BCVA) (p<0.01).

Conclusions Our population-based study revealed that MTM was present in 0.9% of myopic eyes and 7.3% of highly myopic eyes. While greater myopic SE, longer AL, MMD and epiretinal traction are risk factors of MTM, age was not related to MTM. MTM has a negative effect on BCVA.

  • epidemiology
  • imaging
  • retina

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  • Contributors SM: involved in all aspects of its design, conception, grading, analysis, manuscript creation and editing. CS: involved in manuscript creation and editing. CWW and AK: involved in conception and editing. C-ST: involved in analysis and editing. YLW: involved in fundus grading and editing. C-YC, KO-M and TYW: involved in conception and critical revision of the manuscript. QVH: involved in optical coherence tomography grading, conception and editing. SMS: involved in design, conception, analysis, manuscript creation and critical revision of the manuscript.

  • Funding This work was supported by the Singapore Ministry of Health’s National Medical Research Council (NMRC) (grant numbers NMRC/CIRG/1488/2018, NMRC/OFLCG/004a/2018 and NMRC/CIRG/1466/2017).

  • Competing interests None declared.

  • Patient consent for publication Written informed consent was obtained from all subjects.

  • Ethics approval All study procedures were performed in accordance with the tenets of the Declaration of Helsinki as revised in 1989. The study was approved by the centralised institutional review boards of the Singapore Health Services and the domain-specific review board of the National Healthcare Group.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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