Comprehensive analysis of posterior segment characteristics in high myopic Turkish patients.

BACKGROUND

We aimed to investigate the structural characteristics of high myopia (HM) in a Turkish cohort using spectral domain optical coherence tomography (OCT) and evaluate the relationship between axial length (AL) and various retinal, choroidal, and scleral parameters.

METHODS

A retrospective analysis of medical records and imaging data was conducted in HM patients examined at Dokuz Eylül University between January 2019 and January 2023. Eyes were categorized into three groups based on AL: Group 1 (26.00-27.49 mm), Group 2 (27.50-28.99 mm), and Group 3 (≥ 29.00 mm). Retinal, choroidal, and scleral parameters were quantitatively assessed, and posterior segment findings were analyzed across these groups.

RESULTS

A total of 146 eyes from 91 patients (mean age: 46.55 ± 17.05 years) were included. Central foveal thickness was significantly lower in Group 1 compared to Group 2 (p = 0.017). Moreover, Group 1 exhibited lower values for average macular thickness, average macular volume, and scleral sink, along with higher subfoveal choroidal thickness values compared to both Group 2 and Group 3 (p < 0.05 for all comparisons). The most common posterior segment findings were peripapillary atrophy (91.8%), tilted disc (47.3%), vitreomacular adhesion (39.0%), and posterior staphyloma (PS, 27.4%). Group 3 exhibited the most advanced stages of myopic maculopathy among the groups (p = 0.001). 'Plus' lesions, defined as the presence of macular neovascularization (MNV), Fuchs spots, or lacquer cracks, were detected in 14.4% of eyes. Pathologic myopia was diagnosed in 49.3% of eyes, including 47.2% based on myopic maculopathy stage and 0.7% each on the presence of PS, active MNV, or scarred MNV. Active MNV was more frequent in Group 3, while scarred MNV was predominant in Group 2.

CONCLUSIONS

Present findings highlight the progressive nature of structural changes associated with increasing AL in HM patients, emphasizing the importance of early detection and monitoring of posterior segment complications. This study provides valuable insights into the prevalence and distribution of myopia-related complications in a Turkish population, aiding in the clinical management of HM.