Macular changes among adult Egyptian patients with pathological myopiaOA

●AIM:To investigate macular changes characteristics among adults with high myopia in Egypt,and to evaluate the relationship between the degree of myopia and the extent of macular alterations.●METHODS:A series of highly myopic eyes with axial length(AL)≥26.0 mm and/or spherical equivalent(SE)≤−6.0 D were included.All subjects underwent automated refraction,correction of refractive error,AL measurement,and optical coherence tomography(OCT)for macular scanning.Myopic maculopathy(MM)for each eye was recorded,and their association with age,refractive error,and AL was determined.●RESULTS:Among the 427 eyes(mean SE:-11.11±4.34 D,mean AL:27.84±1.66 mm)of 250 subjects(77 males,mean age 56.84±12.19y),all had tigroid fundus(A1,ATN classification of MM),associated macular lesions were chorioretinal atrophy[C-R atrophy;8.47%diffuse C-R atrophy(A2),11.0%patchy C-R atrophy(A3)].Neovascular MM was:lacquer cracks in(N1)1.64%,myopic choroidal neovascularization[mCNV;6.09%active CNV(N2a),19.20%choroidal neovascular membrane(N2b)],myopic traction maculopathy(MTM)in 11.48%,macular hole(MH;3.98%lamellar MH,2.34%full thickness MH).Older age was associated with MTM,MH,and lacquer cracks(P=0.004,P=0.025,P=0.013).More myopic SE was associated with increased odds of atrophic MM,neovascular MM,and MTM(P<0.001,P<0.001,P=0.002).Increased AL was associated with increased odds of atrophic MM,neovascular MM,and dome shape macula(P=0.049,P=0.037,P=0.001).In the multivariable linear mixed model with adjustment of age,gender and SE:the presence of atrophic MM(P<0.001),neovascular MM(P<0.001)were significantly associated with poorer best corrected visual acuity(BCVA).●CONCLUSION:Among adult Egyptian patients with high myopia:age,more myopic SE and longer AL are associated with increased odds of MM.Atrophic or neovascular MM is associated with poorer visual acuity.