Correlation of Visual Acuity and Outer Retinal Thickness in Myopic Atrophic Maculopathy: A Retrospective Review

Cheng Yung Lee, Yun Hsia, Mei Chi Tsui, Shih Wen Wang, Chien Jung Huang, I. Hsin Ma, Kuo Chi Hung, Muh Shy Chen, Tzyy Chang Ho

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Introduction: Myopic atrophic maculopathy is prevalent among patients with pathologic myopia and frequently leads to relentless vision loss. Several grading systems were established to facilitate the understanding of myopic atrophic maculopathy. However, the anatomical details in different stages of myopic maculopathy are so far not clearly elucidated. This study aims to investigate the visual acuity and retinal sublayer features in highly myopic eyes with varying severities of myopic atrophic maculopathy (MAM). Methods: The clinical records of 111 consecutive patients (158 eyes) with high myopia (refractive error ≤ −6.0 D and axial length ≥ 26.0 mm) were reviewed. Fundus photography, optical coherence tomography (OCT), and best-corrected visual acuity (BCVA) were measured. MAM was graded according to the META-analysis for Pathologic Myopia (META-PM) classification system. Myopic choroidal neovascularization (mCNV) and dome-shaped macula (DSM) were also investigated. Results: Among the 158 eyes, 18 (11%), 21(13%), 24 (15%), 25 (16%), 23 (15%), and 24 (15%) had tessellated fundus, diffuse chorioretinal atrophy, diffuse chorioretinal atrophy with DSM, patchy atrophy, patchy atrophy with DSM, and MAM with mCNV, respectively. A total of 23 (15%) eyes had macular atrophy without mCNV. Progressive thinning in the Henle’s fiber and outer nuclear layers, myoid and ellipsoid zone (MEZ), outer segment (OS), and interdigitation zone and retinal pigmented epithelium based on the severity of MAM (p-value < 0.001) was found. MEZ and OS were most significantly reduced in thickness (p-value < 0.001). The presence of mCNV demonstrated significant outer retinal layer thinning compared with that of the tessellated fundus (p-value = 0.031). Patchy atrophy with DSM showed statistically poorer BCVA compared with that without (p-value = 0.008). Conclusion: Visual acuity and outer retinal sublayer characteristics were correlated with the severity of MAM. Outer retinal sublayer analysis by spectrum-domain OCT shed some light on the mechanisms of MAM progression.

Original languageEnglish
Pages (from-to)1989-2003
Number of pages15
JournalOphthalmology and Therapy
Issue number4
Publication statusPublished - Aug 2023


  • Best-corrected visual acuity
  • Dome-shape macula
  • Myopic atrophic maculopathy
  • Myopic choroidal neovascularization
  • Optical coherence tomography
  • Pathologic myopia
  • Retinal thickness

ASJC Scopus subject areas

  • Ophthalmology


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