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Myopic Macular Atrophy in the Two-Continent Population-Based Study.

Jost B Jonas^1,2,3, Mukharram M Bikbov⁴, Gyulli M Kazakbaeva⁴

¹Institut Français de Myopie, Hôpital Fondation Rothschild, Paris, France.

Investigative Ophthalmology & Visual Science

|July 23, 2024

Summary

Bruch's membrane defects (BMDs) and subretinal proliferations (SRPs) are common in advanced myopic macular atrophy (MMD stage 4). These findings, associated with myopic patchy atrophies (MMD stage 3), highlight the link between BMDs and SRPs in high myopia.

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Area of Science:

Ophthalmology
Retinal Diseases
High Myopia Research

Background:

High myopia is a leading cause of visual impairment globally.
Myopic macular degeneration (MMD) encompasses various stages of retinal damage in highly myopic eyes.
Bruch's membrane defects (BMDs) and subretinal proliferations (SRPs) are pathological features observed in advanced stages of MMD.

Purpose of the Study:

To determine the prevalence of Bruch's membrane defects (BMDs) and subretinal proliferations (SRPs).
To investigate these defects in highly myopic eyes with myopic macular atrophy (MMD stage 4) and myopic patchy atrophies (MMD stage 3).
To analyze prevalence across three ethnically diverse, population-based cohorts.

Main Methods:

Population-based studies: Ural Eye and Medical Study (UEMS), Ural Very Old Study (UVOS), and Beijing Eye Study (BES).
Inclusion criteria: Individuals aged 40+ (UEMS, BES) and 85+ (UVOS).
Outcome measures: Prevalence of BMDs and SRPs in eyes with MMD stage 3 and stage 4.

Main Results:

In MMD stage 4, foveal BMDs and SRPs were highly prevalent (89-100%) across cohorts.
MMD stage 3 showed variable prevalence of BMDs (17-71%) and SRPs (11-33%).
BMDs and SRPs were significantly associated with each other, irrespective of MMD stage.

Conclusions:

All assessed eyes with myopic macular atrophy exhibited foveal BMDs and SRPs.
Myopic patchy atrophies could be categorized into those with and without BMDs/SRPs.
A strong, independent association exists between BMDs and SRPs in high myopia.