Jerry Vongphanit1, Paul Mitchell, Jie Jin Wang. 1. Department of Ophthalmology and Save Sight Institute, the University of Sydney and Millenium Institute, Westmead Hospital, Hawkesbury Road, Westmead, NSW, Australia 2145.
Abstract
OBJECTIVE: To determine the prevalence and progression of myopic retinopathy in an older community-based population sample. DESIGN: Population-based epidemiologic study. PARTICIPANTS: Eligible residents aged 49 years or older (n = 3654) who attended the Blue Mountains Eye Study, west of Sydney, Australia. METHODS: Participants had a detailed eye examination including measurement of logarithm of the minimum angle of resolution (logMAR) visual acuity, standardized refraction, and retinal stereophotography. All patients were invited to attend follow-up examinations after 5 years. MAIN OUTCOME MEASURES: Myopic retinopathy was defined to include staphyloma, lacquer cracks, Fuchs' spot and myopic chorioretinal atrophy. beta-peripapillary atrophy was assessed separately. RESULTS: Signs of myopic retinopathy were found in 67 eyes from 44 participants (1.2%), a prevalence of 1.4% in women and 1.0% in men; this increased from 1% in right eyes with myopia <3 diopters to over 50% in right eyes with myopia > or =9 diopters. There was a nonsignificant age-related trend in prevalence. The average spherical equivalent refraction was -6.1 diopters and the average visual acuity was 20/40 in eyes with myopic retinopathy. Visual impairment (<20/40) was present in 38.8% of affected eyes. Myopic retinopathy was bilateral in 52% of cases. Staphyloma was present in 26 participants (0.7%), bilateral in 35%, with a strong concordance of staphyloma location. Lacquer cracks were seen in 8 participants (0.2%), Fuchs' spot in 3 (0.1%), and chorioretinal atrophy in 7 (0.2%). Forty-six eyes (68.7%) with myopic retinopathy were reexamined after 5 years; 8.7% had new or increased numbers of lacquer cracks and 15.2% had new or expanded areas of chorioretinal atrophy. In those eyes developing lacquer cracks or chorioretinal atrophy, best-corrected visual acuity decreased by a mean of two LogMAR lines. CONCLUSIONS: This study documented the age and sex-specific prevalence of myopic retinopathy and 5-year progression in an older white population.
OBJECTIVE: To determine the prevalence and progression of myopic retinopathy in an older community-based population sample. DESIGN: Population-based epidemiologic study. PARTICIPANTS: Eligible residents aged 49 years or older (n = 3654) who attended the Blue Mountains Eye Study, west of Sydney, Australia. METHODS:Participants had a detailed eye examination including measurement of logarithm of the minimum angle of resolution (logMAR) visual acuity, standardized refraction, and retinal stereophotography. All patients were invited to attend follow-up examinations after 5 years. MAIN OUTCOME MEASURES: Myopic retinopathy was defined to include staphyloma, lacquer cracks, Fuchs' spot and myopic chorioretinal atrophy. beta-peripapillary atrophy was assessed separately. RESULTS: Signs of myopic retinopathy were found in 67 eyes from 44 participants (1.2%), a prevalence of 1.4% in women and 1.0% in men; this increased from 1% in right eyes with myopia <3 diopters to over 50% in right eyes with myopia > or =9 diopters. There was a nonsignificant age-related trend in prevalence. The average spherical equivalent refraction was -6.1 diopters and the average visual acuity was 20/40 in eyes with myopic retinopathy. Visual impairment (<20/40) was present in 38.8% of affected eyes. Myopic retinopathy was bilateral in 52% of cases. Staphyloma was present in 26 participants (0.7%), bilateral in 35%, with a strong concordance of staphyloma location. Lacquer cracks were seen in 8 participants (0.2%), Fuchs' spot in 3 (0.1%), and chorioretinal atrophy in 7 (0.2%). Forty-six eyes (68.7%) with myopic retinopathy were reexamined after 5 years; 8.7% had new or increased numbers of lacquer cracks and 15.2% had new or expanded areas of chorioretinal atrophy. In those eyes developing lacquer cracks or chorioretinal atrophy, best-corrected visual acuity decreased by a mean of two LogMAR lines. CONCLUSIONS: This study documented the age and sex-specific prevalence of myopic retinopathy and 5-year progression in an older white population.
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