Prevalence and associated risk factors of myopic maculopathy in elderly Chinese: The Shihpai eye study

PURPOSE. To assess the prevalence and associated risk factors of myopic maculopathy in an elderly Chinese population in Taiwan. METHODS. Population-based, cross-sectional study. A total of 1361 Chinese aged 65 years or older residing in Shihpai, Taipei, Taiwan, underwent a detailed ophthalmic examination. Of the 1361 participants, 1058 subjects had at least one gradable fundus photograph and were recruited for analysis. High myopia was defined as spherical equivalent of less than -6.0 diopter (D) in the phakic eyes or axial length greater than 26.5 mm in pseudophakic or aphakic eyes. Myopic maculopathy was defined as the appearance of lacquer cracks, focal area of deep choroidal atrophy and macular choroidal neovascularization, or geographic atrophy in the presence of high myopia. RESULTS. The prevalence of high myopia was 4.2% (44/1058). Signs of myopic maculopathy were present in 32 (72.7%) of the 44 high myopics, representing a prevalence of 3.0% (95% confidence interval, 2.0%-4.0%). Subjects with high myopia with myopic maculopathy had higher systolic blood pressure than those without maculopathy (146.4±16.2 mm Hg vs. 127.0±15.9 mm Hg, P 1/4 0.001), and the difference persisted (P 1/4 0.018) after adjustment for age, sex, smoking, body mass index, diastolic blood pressure, educational levels, alcohol drinking, and histories of diabetes or taking anti-hypertension medication. Of the 65 high myopic eyes, eyes with maculopathy had a greater myopic degree (_12.8±5.1 D vs. _7.6 61.5 D, P 1/4 0.001) and poorer corrected visual acuity (logMAR 0.72±0.6 vs. 0.27±0.2, P 1/4 0.001) than those without. CONCLUSIONS. The prevalence of high myopia and myopic maculopathy in this elderly Chinese population group was high. Of the major risk factors examined, high systolic blood pressure may be associated with myopic maculopathy.