School of Medicine, Tongji University, Shanghai, China.
Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.
Eye (Lond). 2023 Sep;37(13):2801-2809. doi: 10.1038/s41433-023-02423-0. Epub 2023 Mar 6.
To analyse the topographic characteristics in macular choroidal thickness (mChT) and ocular biometry in myopic maculopathy and to explore the potential cut-off value for prediction of myopic maculopathy (MM).
All participants underwent detailed ocular examinations. MM was subdivided into thin choroid, Bruch's membrane (BM) defects, choroidal neovascularization (CNV), and myopic tractional maculopathy (MTM) according to OCT-based classification system. Peripapillary atrophy area (PPA), tilt ratio, torsion, and mChT were individually measured.
A total of 1947 participants were included. In multivariate logistics models, older age, longer axial length, larger PPA area, and thinner average mChT were more likely to have MM and different type of MM. Female participants were more likely to have MM and BM defects. A lower tilt ratio was more likely to be associated with CNV and MTM. The area under the curve (AUC) of single tilt ratio, PPA area, torsion, and topographic of mChT for MM, thin choroid, BM Defects, CNV, and MTM were 0.6581 to 0.9423, 0.6564 to 0.9335, 0.6120 to 0.9554, 0.5734 to 0.9312, 0.6415 to 0.9382, respectively. After combining PPA area and average mChT for predicting MM, thin choroid, BM defects, CNV, and MTM, the AUC of the combination were 0.9678, 0.9279, 0.9531, 0.9213, 0.9317, respectively.
Progressive and continuous PPA area expanding and thin choroid play a role in the development of myopic maculopathy. The present study showed that a combination of peripapillary atrophy area and the choroidal thickness could be used to predict MM and each type of MM.
分析近视性黄斑病变患者黄斑脉络膜厚度（mChT）的地形特征和眼部生物测量，并探讨预测近视性黄斑病变（MM）的潜在截断值。
所有参与者均接受详细的眼部检查。根据基于 OCT 的分类系统，将 MM 分为薄脉络膜、Bruch 膜（BM）缺损、脉络膜新生血管（CNV）和近视牵引性黄斑病变（MTM）。分别测量视盘周围萎缩区（PPA）、倾斜比、扭转和 mChT。
共纳入 1947 名参与者。在多变量逻辑模型中，年龄较大、眼轴较长、PPA 面积较大、平均 mChT 较薄的患者更有可能发生 MM 及不同类型的 MM。女性患者更有可能发生 MM 和 BM 缺损。较低的倾斜比更可能与 CNV 和 MTM 相关。单一倾斜比、PPA 面积、扭转和 mChT 地形对 MM、薄脉络膜、BM 缺损、CNV 和 MTM 的曲线下面积（AUC）分别为 0.6581 至 0.9423、0.6564 至 0.9335、0.6120 至 0.9554、0.5734 至 0.9312、0.6415 至 0.9382。在联合 PPA 面积和平均 mChT 预测 MM、薄脉络膜、BM 缺损、CNV 和 MTM 后，联合的 AUC 分别为 0.9678、0.9279、0.9531、0.9213、0.9317。
进行性和连续性 PPA 面积扩大和薄脉络膜在近视性黄斑病变的发展中起作用。本研究表明，视盘周围萎缩区和脉络膜厚度的联合可以用于预测 MM 和每种类型的 MM。
