PT  - JOURNAL ARTICLE
AU  - Yee Ling Wong
AU  - Xiangjia Zhu
AU  - Yih Chung Tham
AU  - Jason C S Yam
AU  - Keke Zhang
AU  - Charumathi Sabanayagam
AU  - Carla Lanca
AU  - Xiujuan Zhang
AU  - So Young Han
AU  - Wenwen He
AU  - Pradeep Susvar
AU  - Mihir Trivedi
AU  - Nan Yuan
AU  - Sarang Lambat
AU  - Rajiv Raman
AU  - Su Jeong Song
AU  - Ya Xing Wang
AU  - Mukharram M Bikbov
AU  - Vinay Nangia
AU  - Li Jia Chen
AU  - Tien Yin Wong
AU  - Ecosse Luc Lamoureux
AU  - Chi-Pui Pang
AU  - Ching Yu Cheng
AU  - Yi Lu
AU  - Jost B Jonas
AU  - Seang Mei Saw
ED  - ,
TI  - Prevalence and predictors of myopic macular degeneration among Asian adults: pooled analysis from the Asian Eye Epidemiology Consortium
AID  - 10.1136/bjophthalmol-2020-316648
DP  - 2021 Aug 01
TA  - British Journal of Ophthalmology
PG  - 1140--1148
VI  - 105
IP  - 8
4099  - http://bjo.bmj.com/content/105/8/1140.short
4100  - http://bjo.bmj.com/content/105/8/1140.full
SO  - Br J Ophthalmol2021 Aug 01; 105
AB  - Aims To determine the prevalence and predictors of myopic macular degeneration (MMD) in a consortium of Asian studies.Methods Individual-level data from 19 885 participants from four population-based studies, and 1379 highly myopic participants (defined as axial length (AL) >26.0 mm) from three clinic-based/school-based studies of the Asian Eye Epidemiology Consortium were pooled. MMD was graded from fundus photographs following the meta-analysis for pathologic myopia classification and defined as the presence of diffuse choroidal atrophy, patchy chorioretinal atrophy, macular atrophy, with or without ‘plus’ lesion (lacquer crack, choroidal neovascularisation or Fuchs’ spot). Area under the curve (AUC) evaluation for predictors was performed for the population-based studies.Results The prevalence of MMD was 0.4%, 0.5%, 1.5% and 5.2% among Asians in rural India, Beijing, Russia and Singapore, respectively. In the population-based studies, older age (per year; OR=1.13), female (OR=2.0), spherical equivalent (SE; per negative diopter; OR=1.7), longer AL (per mm; OR=3.1) and lower education (OR=1.9) were associated with MMD after multivariable adjustment (all p<0.001). Similarly, in the clinic-based/school-based studies, older age (OR=1.07; p<0.001), female (OR=2.1; p<0.001), longer AL (OR=2.1; p<0.001) and lower education (OR=1.7; p=0.005) were associated with MMD after multivariable adjustment. SE had the highest AUC of 0.92, followed by AL (AUC=0.87). The combination of SE, age, education and gender had a marginally higher AUC (0.94).Conclusion In this pooled analysis of multiple Asian studies, older age, female, lower education, greater myopia severity and longer AL were risk factors of MMD, and myopic SE was the strongest single predictor of MMD.