Title: Five-Year cumulative Incidence and Progression of Myopic Maculopathy in the German population – results from the Gutenberg Health Study
Authors: Susanne Hopf1 , Franziska Heidt1,4 , Christina A. Korb1 , Andreas Schulz2 , Thomas Münzel3 , Philipp S. Wild2,4 , Manfred E. Beutel5 , Irene Schmidtmann6 , Karl J. Lackner7 , Norbert Pfeiffer1 , Alexander K. Schuster1
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Preventive Cardiology and Preventive Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Mainz, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
Reference: ARVO 2021 abstract and video presentation
This study utilized data from over 15,000 participants aged 35-74 years and found a five-year cumulative incidence (new onset) of myopic maculopathy in the general population of 3 in 1,000. In 509 eyes with over 6D of myopia, 7% had myopic maculopathy and of these 50% worsened over the study period. There was a correlation between higher IOP and progression of maculopathy. This is the first such data available in a European population.
What this means for your clinical practice: Myopic maculopathy is infrequent in the general adult population but occurred in 7% of high myopes, and half of these showed progression. Adults of any age with high myopia should be monitored closely for retinal pathology.
Purpose: To investigate the five-year cumulative incidence and progression of myopic maculopathy in the general population in Germany and to analyze potential risk factors.
Methods: The Gutenberg Health Study (GHS) is a population-based cohort study, including 15,010 participants aged 35 to 74 years at baseline. Myopic maculopathy incidence and progression was assessed by grading of fundus photographs according to a recent international photographic classification system (META-PM), in phakic eyes with spherical equivalent ≤ -6D (baseline). 509 eyes of 334 participants (mean age 50.4 ± 9.2 years; median: -7.25D myopic refractive error) without myopic maculopathy at baseline and 34 eyes of 27 subjects (mean age 56.7 ± 9.1 years; median -9D myopic refractive error) with myopic maculopathy met the conditions and had gradable fundus photographs at baseline and five-year follow-up. Multivariable logistic regression analysis was used to assess risk factors for progression of myopic maculopathy.
Results: 5-year cumulative incidence of myopic maculopathy was 0.3% (95%CI: 0.02-1.92%; n=1). Progression occurred in 17 of 34 eyes (50%) with prior myopic maculopathy over 5 years with 4 changes in category. The most common types of progression were enlargement of chorioretinal and patchy atrophy; a new pathology was present in 8 eyes. Higher IOP (OR=1.62, 95%CI: 1.03-2.53, p=0.035) was associated with progression of myopia, while female gender (OR=5.54, 95%CI: 0.93-32.92, p=0.060) and higher myopic refractive error (OR=1.62 per diopter, 95%CI: 0.99-1.49, p=0.063) showed a tendency towards progression.
Conclusions :Incidence of myopic maculopathy is rare in highly myopic eyes in the general population in Germany at age 35 to 74 years. Progression of eyes with myopic maculopathy in the German population occurred in 50% of prior diseased highly myopic eyes. These population-based five-year follow-up data on incidence and progression of myopic maculopathy are the first in Europe.
Disclosures: Susanne Hopf, None; Franziska Heidt, None; Christina A. Korb, None; Andreas Schulz, None; Thomas Münzel, None; Philipp S. Wild, None; Manfred E. Beutel, None; Irene Schmidtmann, None; Karl J. Lackner, None; Norbert Pfeiffer, None; Alexander K. Schuster, None