Work

Clinical Features and Natural Progression of Unilateral High Myopia in Adults: A Comparison Study

Year: 2025

Type: article

Abstract: Purpose: To investigate and compare the clinical characteristics of patients with unilateral high myopia (UHM) and bilateral high myopia (BHM) based on axial length (AL). Design: A retrospective cohort study. Participants: Adult patients diagnosed with UHM or BHM between March 2011 and August 2021. Methods: Unilateral high myopia was defined as ≥26 mm AL in 1 eye and <26 mm in the other, with ≥2 mm difference. Bilateral high myopia was defined as ≥26 mm AL in both eyes, with ≤3 mm difference. In each patient, the eye with the longer AL was designated the "longer eye" and the other the "shorter eye." We analyzed differences in clinical features, including ophthalmic history, best-corrected visual acuity, ocular biometry, and myopic maculopathy grade. Myopic maculopathy was graded based on atrophy, traction, and neovascularization using a known method. Long-term features included treatments for myopic neovascular maculopathy and myopic tractional maculopathy and AL change over time. Main Outcome Measures: Comparison of clinical characteristics between UHM and BHM groups. Results: < 0.01). Conclusions: Adult UHM patients mostly lacked associated environmental factors. The poorer visual acuity in the longer eyes of UHM patients, which cannot be explained by structural abnormalities, suggests that the interocular difference may have originated in early childhood. During the follow-up period, AL elongation and myopic complications occurred at similar rates in the longer eye of UHM and both eyes of BHM. Meanwhile, such changes were not observed in the shorter eye in UHM. Further investigation of the underlying mechanisms, such as the genetic factors contributing to this extreme asymmetry, is warranted. Financial Disclosures: The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Source: Ophthalmology Science

DOI: 10.1016/j.xops.2025.100780