TY - JOUR
T1 - Correlation of Visual Acuity and Outer Retinal Thickness in Myopic Atrophic Maculopathy
T2 - A Retrospective Review
AU - Lee, Cheng Yung
AU - Hsia, Yun
AU - Tsui, Mei Chi
AU - Wang, Shih Wen
AU - Huang, Chien Jung
AU - Ma, I. Hsin
AU - Hung, Kuo Chi
AU - Chen, Muh Shy
AU - Ho, Tzyy Chang
N1 - Funding Information:
The authors sincerely thank all study participants for their invaluable data. No funding or sponsorship was received for this study or publication of this article. The Rapid Service Fee was funded by the authors. Free resources of statistics were used from the website of the statistics education center. Yu-Cheng Lee, who is affiliated to the College of Medicine at National Taiwan University, helped us with the statistics. No funding was involved in the statistical analysis process. Cheng-Yung Lee, Yun Hsia, Mei-Chi Tsui, Shih-Wen Wang, Chien-Jung Huang, I-Hsin Ma, Kuo-Chi Hung, Muh-Shy Chen, and Tzyy-Chang Ho contributed to the study conception and design. Material preparation, data collection and analysis were performed by Cheng-Yung Lee, Yun Hsia, and I-Hsin Ma. The first draft of the manuscript was written by Cheng-Yung Lee. Cheng-Yung Lee, Yun Hsia, Mei-Chi Tsui, Shih-Wen Wang, Chien-Jung Huang, I-Hsin Ma, Kuo-Chi Hung, Muh-Shy Chen, and Tzyy-Chang Ho commented on the previous versions of the manuscript. And finally, Cheng-Yung Lee, Yun Hsia, Mei-Chi Tsui, Shih-Wen Wang, Chien-Jung Huang, I-Hsin Ma, Kuo-Chi Hung, Muh-Shy Chen, and Tzyy-Chang Ho read and approved the final manuscript. Cheng-Yung Lee, Yun Hsia, Mei-Chi Tsui, Shih-Wen Wang, Chien-Jung Huang, I-Hsin Ma, Kuo-Chi Hung, Muh-Shy Chen, and Tzyy-Chang Ho declare that they have no competing interests. This study was approved by the Ethics Committee and Institutional Review Board of the National Taiwan University Hospital (reference numbers: 202112074RINA). This study was performed in accordance with the Helsinki Declaration of 1964, and its later amendments. Due to the retrospective nature of the study, the waiver of informed consent was approved by the Institutional Review Board listed above. No identifying information is included in the manuscript. Data sharing is not applicable to this article as no datasets were generated or analyzed in the current study.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/8
Y1 - 2023/8
N2 - 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.
AB - 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.
KW - Best-corrected visual acuity
KW - Dome-shape macula
KW - Myopic atrophic maculopathy
KW - Myopic choroidal neovascularization
KW - Optical coherence tomography
KW - Pathologic myopia
KW - Retinal thickness
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U2 - 10.1007/s40123-023-00710-3
DO - 10.1007/s40123-023-00710-3
M3 - Article
AN - SCOPUS:85159369935
SN - 2193-8245
VL - 12
SP - 1989
EP - 2003
JO - Ophthalmology and Therapy
JF - Ophthalmology and Therapy
IS - 4
ER -