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Pathologic myopia in highly myopic patients with high axial anisomyopia
  1. Jonathan Li1,2,
  2. Yee Shan Dan3,
  3. Si Qi Chua3,
  4. Qiu Ying Wong3,
  5. Rachel S Chong1,3,
  6. Marcus Ang1,3,
  7. SNEC Retina Group1,
  8. Chee Wai Wong1,
  9. Quan V Hoang1,3,4,5
  1. 1Department of Ophthalmology, Singapore National Eye Centre, Singapore
  2. 2Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
  3. 3Singapore Eye Research Institute, Singapore
  4. 4Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  5. 5Duke-NUS Medical School, Singapore
  1. Correspondence to Dr Quan V Hoang, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore; donny.hoang{at}singhealth.com.sg

Abstract

Purpose To determine prevalence of anisomyopia (axial length (AL) difference ≥2.5 mm) among high myopes ((HMs), defined by spherical equivalent of ≤6.0 diopters or AL ≥ 26.5 mm). To characterise the shorter anisomyopic eye (SAE) and evaluate if pathologic myopia (PM) in the longer anisomyopic eye (LAE) was associated with increased risk of PM in the SAE.

Methods 1168 HMs were recruited from Singapore National Eye Centre clinic for this cross-sectional study. Biometry, fundus photography and swept-source optical coherence tomography were performed. Patients with high axial anisomyopia were identified. Structural characteristics and presence of PM were described. Stepwise multivariate regression explored associations between PM in the LAE and pathology in the SAE, controlling for confounding variables.

Results Prevalence of anisomyopia was 15.8% (184 of 1168 patients). Anisomyopic patients (age 65.8±13.5 years) had mean AL of 30.6±2.0 mm and 26.2±2.3 mm in the LAE and SAE, respectively. 52.7% of SAEs had AL < 26.5 mm. Prevalence of myopic macular degeneration, macula-involving posterior staphyloma (PS), myopic traction maculopathy (MTM) and myopic choroidal neovascularisation (mCNV) in the SAE was 52.2%, 36.5%, 13.0% and 8.2%, respectively. Macular hole in the LAE was associated with increased risk of MTM in the SAE (OR=4.88, p=0.01). mCNV in the LAE was associated with mCNV in the SAE (OR=3.57, p=0.02). PS in the LAE was associated with PS in the SAE (OR=4.03, p<0.001).

Conclusions Even when controlled for AL, PM complications in the LAE predict similar PM complications in the SAE. Patients with high axial anisometropia with PM in the LAE should be monitored carefully for complications in the SAE.

  • Retina
  • Optics and Refraction
  • Imaging

Data availability statement

Data are available upon reasonable request. Data includes deidentified participant data, available from first author (ORCID 0000-0002-8004-0015) upon request. Data is owned by Singapore National Eye Centre and reuse is not permitted.

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Data availability statement

Data are available upon reasonable request. Data includes deidentified participant data, available from first author (ORCID 0000-0002-8004-0015) upon request. Data is owned by Singapore National Eye Centre and reuse is not permitted.

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Footnotes

  • Contributors QVH, RC and CWW conceived and designed the study. JL, YSD, SQC and QYW contributed to analysis of data. JL lead the analysis and interpretation of the data and drafted the manuscript. All authors (JL, YSD, SQC, QYW, RC, HNMA, SRG, CWW and QVH) contributed to the acquisition of data, critical review and final approval of the manuscript and agree to be accountable for all aspects of the work. QVH is the guarantor.

  • Funding This work was supported in part by the Singapore National Medical Research Council (grant CSA/MOH-000151/2019, QVH).

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.