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DIFFUSE CHORIORETINAL ATROPHY IN CHINESE HIGH MYOPIA

The ZOC-BHVI High Myopia Cohort Study

Liu, Ran, MD*; Guo, Xinxing, MD, PhD*,†; Xiao, Ou, MD, PhD*; Li, Zhixi, MD, PhD*; Zhang, Jian, MS*; Lee, Jonathan Tak Loong, MBBS; Wang, Decai, MD, PhD*; Sankaridurg, Padmaja, PhD§; Jong, Monica, PhD, BOptom§; He, Mingguang, MD, PhD*,‡

doi: 10.1097/IAE.0000000000002397
Original Study: PDF Only

Purpose: To explore the associations between diffuse chorioretinal atrophy (DCA) and age, sex, axial length, spherical equivalent, and best-corrected visual acuity (BCVA) among highly myopic eyes.

Methods: This study included right eyes of 857 bilaterally highly myopic individuals from the ZOC-BHVI Cohort Study. Participants underwent examinations, including BCVA, ocular biometry, autorefraction, and color fundus photography. An Early Treatment Diabetic Retinopathy Study grid was applied on the fundus photographs to evaluate the location of DCA, which was graded into four categories (D0–D3). The characteristics and ocular biometry were compared between participants' eyes with and without DCA.

Results: Diffuse chorioretinal atrophy was found in 177 (20.6%) eyes. The proportion of participants with DCA in age groups of 7 to 11, 12 to 18, 19 to 39, and ≥ 40 years old was 20.9%, 9.2%, 23.1%, and 52.9%, respectively. The proportion of DCA significantly increased with longer axial length and worse myopic spherical equivalent. Eyes with DCA had poorer BCVA (Snellen visual acuity 20/36, logarithm of minimal angle of resolution 0.26 ± 0.25) than those without DCA (Snellen visual acuity 20/23, logarithm of minimal angle of resolution 0.06 ± 0.14) (P < 0.001). The BCVA gradually declined as the lesion got closer to the fovea (P for trend < 0.001).

Conclusion: The proportion of DCA increased with older age, longer axial length, and more myopic spherical equivalent. Diffuse chorioretinal atrophy is a vision-threatening complication of high myopia where BCVA gradually worsens with foveal involvement.

The proportion of diffuse chorioretinal atrophy in highly myopic eyes increased with older age, longer axial length, and more myopic refractive error. Diffuse chorioretinal atrophy is a vision-threatening complication of high myopia where best-corrected visual acuity gradually worsens with foveal involvement.

*State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China;

Dana Center of Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland;

Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia; and

§Brien Holden Vision Institute, Sydney, Australia.

Reprint requests: Mingguang He, State Key Laboratory of Ophthalmology, zhongshan Ophthalmic Center, Sun Yat-sen University, 54 Xianlie Road, Yuexiu District, Guangzhou, Guangdong 510060, People's Republic of China; e-mail: mingguang.he@unimelb.edu.au

Supported by the Fundamental Research Funds of the State Key Laboratory of Ophthalmology, National Natural Science Foundation of China (81125007), Science and Technology Planning Project of Guangdong Province (2013B20400003), and a grant from Brien Holden Vision Institute, Australia. D. Wang receives support from National Natural Science Foundation of China (81271037). M. He receives support from the University of Melbourne at Melbourne Accelerator Program Professorship. The Centre for Eye Research Australia receives operational infrastructural support from the Victorian government. Sponsor or funding organization had no role in the design or conduct of this research.

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.