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Published on: April 3, 2016
[Risk factors associated with myopic maculopathy in acquired myopia]
O V Kolenko1,2,3, L V Bushnina1, I E Pashentsev1
1Khabarovsk branch of the S.N. Fedorov National Medical Research Centre "MNTK "Eye Microsurgery", Khabarovsk, Russia.
Purpose:
This study aimed to identify factors associated with the development of myopic maculopathy (MM) in patients with acquired myopia.
Material And Methods:
The study included a total of 135 patients (41 men, 94 women; 135 eyes) over 30 years old with acquired myopia and axial length (AL) of 26 mm. Forty-six patients had MM, while 89 (66%) had no macular changes. Optical coherence tomography angiography (OCT-A) and B-scan ultrasound of the eyes were performed to detect staphylomas of the posterior pole sclera. OCT was used to assess corneal stromal thickness and choroidal thickness. Corneal biomechanics were measured using the Corvis ST device, and ocular vessel hemodynamics were evaluated using color Doppler imaging. Binary logistic regression was employed, with a multivariable logistic model built for each of these potential risk factors, adjusted for sex, age, AL, and spherical equivalent (SE).
Results:
Age, AL, SE, and extra-macular myopic changes were significantly associated with the presence of MM. Of the seven qualitative risk factors studied, the presence of extra-macular changes, staphyloma, and wide macular staphyloma localization were statistically significant. Among the quantitative factors, significant associations were found with the width and depth of staphyloma, the area of the ultrasound cross-section of staphyloma (W×D), choroidal thickness in all examined zones, all corneal stromal thickness parameters, corneal deformation amplitude (DA), curvature radius highest concavity (radius HC), and corneal peak distance (PD).
Conclusion:
The statistically significant risk factors associated with MM were age, AL, SE, the presence and size of staphylomas, choroidal and corneal stromal thickness, as well as several parameters characterizing corneal biomechanical properties. The strongest associations with MM were found for corneal PD, staphyloma depth, and choroidal thickness in the nasal perifovea.
Insights
This study identified key factors contributing to myopic maculopathy (MM) in adults with acquired myopia. Corneal biomechanics, staphyloma characteristics, and choroidal thickness are strongly linked to MM development.
Area of Science:
- Ophthalmology
- Optometry
- Biomedical Engineering
Context:
- Myopic maculopathy (MM) is a leading cause of vision impairment in individuals with high myopia.
- Understanding the etiological factors of MM is crucial for developing effective prevention and treatment strategies.
- Acquired myopia presents unique challenges in assessing MM risk factors compared to congenital myopia.
Purpose:
- To identify and analyze the specific factors associated with the development of myopic maculopathy (MM) in patients diagnosed with acquired myopia.
- To investigate the role of ocular structural and biomechanical properties in the pathogenesis of MM.
- To establish a comprehensive risk profile for MM in a cohort of adult myopic patients.
Summary:
- The study analyzed 135 patients with acquired myopia (age >30, axial length ≥26 mm), assessing MM presence using OCT-A and ultrasound.
- Risk factors evaluated included age, axial length (AL), spherical equivalent (SE), staphyloma characteristics, choroidal and corneal thickness, and corneal biomechanics.
- Significant associations with MM were found for age, AL, SE, extra-macular changes, staphyloma presence/size, choroidal thickness, corneal stromal thickness, and various corneal biomechanical parameters (DA, radius HC, PD).
Impact:
- Identifies specific corneal biomechanical properties (e.g., corneal peak distance) and ocular structural metrics (staphyloma depth, nasal perifoveal choroidal thickness) as the strongest predictors of MM.
- Provides valuable insights for ophthalmologists and optometrists in assessing MM risk and potentially guiding interventions.
- Highlights the importance of a multi-faceted approach, considering both structural and biomechanical aspects of the eye in myopia management.
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