Characteristics of myopic traction maculopathy in myopic Singaporean adults

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

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).

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).

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.