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Retina
Risk factors and patterns for progression of fellow-eye myopic traction maculopathy: a 3-year retrospective cohort study
  1. Nan Luo1,
  2. Kejun Long1,
  3. Ping Lian1,
  4. Jieyong Huang1,
  5. Liyi Zhao1,
  6. Subinuer Alimu1,
  7. Guang Liu2,
  8. Ling Jin1,
  9. Tong Wang1,
  10. Chen Chen1,
  11. Yanqiao Huang1,
  12. Xiujuan Zhao1,
  13. Xiling Yu1,
  14. Xiaoyan Ding1,
  15. Jingjing Huang1,
  16. Bingqian Liu1,
  17. Shida Chen1,
  18. Lin Lu1
  1. 1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
  2. 2Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
  1. Correspondence to Dr Shida Chen, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; chenshd3{at}mail.sysu.edu.cn; Dr Bingqian Liu, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; liubq6{at}mail.sysu.edu.cn

Abstract

Aims To investigate the effect of preretinal tractional structures (PTS) and posterior scleral structures (PSS) on myopic traction maculopathy (MTM) progression.

Methods This retrospective cohort study included 185 fellow highly myopic eyes of 185 participants who underwent surgery for MTM. PTS included epiretinal membrane, incomplete posterior vitreous detachment and their combination. PSS included posterior staphyloma and dome-shaped macula (DSM). The MTM stage was graded according to the Myopic Traction Maculopathy Staging System. Optical coherence tomography was used to identify MTM progression, defined as an upgrade of MTM. The Kaplan-Meier method with log-rank test was used to assess MTM progression over the 3-year follow-up period. Risk factors for progression were identified using Cox regression analysis.

Results MTM progression was observed in 48 (25.9%) eyes. Three-year progression-free survival (PFS) rates for eyes with PTS, staphyloma and DSM were 53.7%, 58.2% and 90.7%, respectively. Eyes with PTS and staphyloma exhibited lower 3-year PFS rates than those without PTS or staphyloma (Plog-rank test =0.002 and <0.001), while eyes with DSM had a higher 3-year PFS rate than eyes without DSM (Plog-rank test=0.01). Multivariate Cox regression analysis showed that PTS (HR, 3.23; p<0.001) and staphyloma (HR, 7.91; p<0.001) were associated with MTM progression, whereas DSM (HR, 0.23; p=0.046) was a protective factor.

Conclusion Both PTS and PSS play a critical role in the progression of MTM. Addressing these factors can aid in the management of MTM.

  • Retina
  • Macula
  • Risk Factors
  • Vitreous
  • Sclera and Episclera

Data availability statement

Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding authors (SC and BL) upon reasonable request.

https://doi.org/10.1136/bjo-2024-325274

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    Data availability statement

    Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding authors (SC and BL) upon reasonable request.

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    Footnotes

    • NL and KL are joint first authors.

    • NL and KL contributed equally.

    • Contributors Study concept and design: BL, SC and LL. Acquisition, analysis or interpretation of data: all authors. Drafting of the manuscript: NL, KL and SC. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: NL, KL, PL, JH, LZ, SA and LJ. Obtained funding: SC and LL. Administrative, technical or material support: GL, TW, CC, LJ, YH, XZ and ZY. Supervision: XD, JH, BL, SC and LL. SC and BL are responsible for the overall content of this manuscript.

    • Funding This study was supported by the Innovative Clinical Technique of Guangzhou (grant 2024P-GX02), the Science and Technology Program of Guangzhou, China (grant 202201020362 and grant 2024A03J00515) and the Lumitin Vision to Brightness Research Funding for the Young and middle-aged Ophthalmologists (grant BCF-KH-YK-20230803-03).

    • Competing interests LL reported research grants from the Innovative Clinical Technique of Guangzhou (grant 2024P-GX02) during the conduct of the study. SC reported research grants from the Science and Technology Program of Guangzhou, China (grant 202201020362 and grant 2024A03J00515) and the Lumitin Vision to Brightness Research Funding for the Young and middle-aged Ophthalmologists (grant BCF-KH-YK-20230803-03) during the conduct of the study.

    • 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.