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Characteristics of myopic maculopathy in Chinese children and adolescents with high myopia
  1. Feng Jiang1,
  2. Ou Xiao1,
  3. Xinxing Guo2,
  4. Qiuxia Yin1,
  5. Lixia Luo1,
  6. Mingguang He3,4,5,
  7. Zhixi Li1
  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. 2Wilmer Eye Institute, Johns Hopkins University, Maryland, Baltimore, USA
  3. 3School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, People's Republic of China
  4. 4Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong, People's Republic of China
  5. 5Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong, People's Republic of China
  1. Correspondence to Dr Zhixi Li; lzx11-11{at}163.com

Abstract

Aims To investigate the characteristics of myopic maculopathy among highly myopic Chinese children and adolescents and explore its associated risk factors.

Methods Children and adolescents aged 7–17 years with spherical equivalent (SE) ≤ −6.00 dioptres (D) were recruited. Myopic maculopathy was categorised based on the International Meta-Analysis of Pathological Myopia Classification. The extent of diffuse choroidal atrophy (DCA) was classified using Early Treatment Diabetic Retinopathy Study grid (ETDRS). The area of DCA was categorised into three classes relative to optic disk area (DA): A1 (≤1 DA), A2 (1 to ≤5 DA) and A3 (5 to ≤10 DA). Logistic regression was used to identify risk factors associated with myopic maculopathy.

Results Of the 425 participants aged 13.66±2.67 years, the proportions of tessellated fundus and DCA were 11.76% and 12.24%, and no more severe fundus lesions or ‘plus’ lesions. The proportion of DCA was 27.03% in children under 11, significantly higher than the 9.12% observed in those aged 11 and older (p<0.001). The percentages of DCA involving the outer, middle and central circles of the ETDRS grid were 42.31%, 55.77% and 1.92%. Myopic maculopathy was significantly associated with younger age (p<0.001), longer axial length (AL; p<0.001) and larger β-zone peripapillary atrophy (β-PPA; p=0.012).

Conclusion In highly myopic children and adolescents, myopic maculopathy predominantly manifested as DCA (12.24%), with no cases of worse myopic maculopathy or ‘plus’ lesions. Younger age, longer AL and larger β-PPA were risk factors for myopic maculopathy.

  • Retina
  • Risk Factors
  • Epidemiology
  • Child health (paediatrics)

Data availability statement

No data are available.

https://doi.org/10.1136/bjo-2023-324430

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    Data availability statement

    No data are available.

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    Footnotes

    • MH and ZL contributed equally.

    • Contributors MH and ZL had full access to all the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. ZL is the primary corresponding author and MH is the coauthor designee in the event that the corresponding author is unavailable. MH and ZL are guarantors. FJ is the first author. Concept and design: FJ, ZL and MH. Acquisition, analysis or interpretation of data: FJ, OX, XG, QY and LL. Drafting of the manuscript: FJ and ZL. Critical revision of the manuscript for important intellectual content: ZL and MH. Statistical analysis: FJ and ZL. Obtained funding: ZL and MH. Administrative, technical or material support: QY, OX, XG, ZL and MH. Supervision: LL, ZL and MH.

    • Funding This study was supported by the National Natural Science Foundation of China (82301249, 82371086), Natural Science Foundation of Guangdong Province (2024A1515010338), the Science and Technology Projects in Guangzhou (2024A04J4472), the Fundamental Research Funds of the State Key Laboratory of Ophthalmology (83000-32030003). The study was in part supported by Global STEM Professorship Scheme (P0046113).

    • Competing interests None declared.

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