Progression of Myopic Maculopathy Based on the ATN Classification System

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Myopic maculopathy (MM) is a leading cause of irreversible vision impairment and central vision loss.
• Understanding the risk factors for MM progression is crucial for timely intervention and management.

Purpose of the Study:

• To evaluate risk factors associated with the progression of myopic maculopathy (MM) using the ATN classification system.
• To identify specific ocular parameters that predict MM progression in high myopia patients.

Main Methods:

• Retrospective analysis of clinic data from 69 high myopia patients (age > 40) with over 2 years of follow-up.
• Fundus photography and OCT examinations were used to assess ATN classification changes.
• Factors analyzed included axial length (AL), spherical equivalence (SE), subfoveal choroidal thickness (SFCT), disc-foveal distance (DFD), optic disc tilt, and parapapillary atrophy (PPA).

Main Results:

• MM progression rate was approximately 25.56% in the study cohort.
• Elongated DFD and thinner SFCT at baseline were significantly associated with MM progression.
• DFD was identified as a substantial hazard risk factor (adjusted OR = 1.672), with a cut-off value of 5.15 mm predicting progression (AUC: 0.794).
• Progression group showed older age, longer AL, higher optic disc tilt, and more pre-existing PPA at baseline.

Conclusions:

• MM progression is associated with older age, longer AL, high disc tilt, pre-existing PPA, thinner SFCT, and longer DFD.
• DFD is a key predictor of MM progression, with lengths > 5.15 mm indicating a higher risk.
• The ATN classification system aids in identifying progression risk factors in high myopia.