Reading Performances in Highly Myopic Patients and Correlation with the Topography of Atrophic Maculopathy

To evaluate how the topography of atrophic patches influences monocular and binocular reading performances in eyes with pathologic myopia.

Prospective single-center observational investigation.

Sixty-two patients (112 eyes) affected by pathologic myopia (axial length [AXL] >26.5 mm). Only college graduates aged <65 years were selected.

All patients underwent monocular and binocular reading evaluation using Colenbrander Reading Charts, taking into account the reading time and missed words/errors. Moreover, eyes underwent fundus photography and autofluorescence: the presence of chorioretinal atrophy within the central, 4 inner, and 4 outer ETDRS grid subfields was reviewed.

Reading acuity (logarithm of the reading acuity determination [logRAD]); reading speed (words per minute [wpm]); percentage of errors/missed word; correlation with ETDRS subfield atrophy localization.

Mean AXL was 31.45 ± 2.21 mm. Monocularly, mean reading acuity was 0.37 ± 0.35 logRAD with an 8% ± 11% rate of missed or wrong words, whereas reading speed was 71.5 ± 27.8 wpm (range 25-125 wpm). Binocularly, mean reading acuity was 0.16 ± 0.16 logRAD with 5% ± 7% of missed or wrong words, whereas reading speed was 88.2 ± 18.0 wpm. Reading acuity was significantly associated with the presence of chorioretinal atrophy in the foveal central circle in univariate and multivariate analysis (P = 0.002). Conversely, reading speed negatively correlated with inner right subfield involvement in multivariate analysis (P = 0.008). Binocularly, reading acuity was associated with the presence of bilateral central atrophy (P = 0.001), whereas reading speed was associated with the presence of chorioretinal atrophy in the inner subfields on the horizontal plane in both eyes: bilateral inner right (P = 0.007) or inner left (P = 0.014) subfields; inner left OD (right eye)-inner right OS (left eye) (P = 0.002); inner right OD-inner left OS (P = 0.004).

In highly myopic eyes, we reported a significant relationship between the topography of patchy chorioretinal atrophy and reading performance.

The author(s) have no proprietary or commercial interest in any materials discussed in this article.