Changes of the Optic Nerve Head and Macula in High Myopia in a 10-Year Follow-Up: The Beijing Eye Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Purpose: To assess the incidence of myopic changes of the optic nerve head and macula in highly myopic eyes. Methods: All highly myopic eyes (axial length >26.0 mm or refractive error ≤-6.0 diopters) examined in the longitudinal population-based Beijing Eye Study 2001/2011 underwent fundus photography (2001/2011) and optic coherence tomography (2011). Results: The study included 89 highly myopic eyes (patient age, 65.0 ± 9.8 years). Progressive macula changes were detected in 63 of 89 eyes (71%), including increases in fundus tessellation (n = 61 [69%]), diffuse chorioretinal atrophy (n = 15 [17%]), lacquer cracks (n = 12 [14%]), patchy atrophies (n = 8 [9%]), macular atrophy (n = 6 [7%]), and overall myopic macular degeneration stage (n = 23 [26%]). Without considering fundus tessellation changes, any macular change was detected in 31 of 80 eyes (35%). Progressive optic nerve head changes were found in 69 of 89 eyes (78%), including optic disc diminution (n = 28 [32%]), disc enlargement (n = 13 [15%]), change in disc shape (n = 36 [40%]), enlargement in beta/gamma zone (n = 68 [76%]) or delta zone (n = 22 [25%]), and lengthening of parapapillary retinal vessels (n = 47 [53%]). Any type of progression of the macula and/or optic nerve head was detected in 74 of 89 eyes (83%), and without considering fundus tessellation changes in 70 of 89 eyes (79%). Higher incidence of any macular change (fundus tessellation change not considered) and of optic nerve head changes correlated with longer axial length (odds ratio [OR], 2.15 [P < 0.001] and OR, 2.20 [P = 0.02], respectively) and older age (OR, 1.11 [P = 0.001] and OR, 1.08 [P = 0.02], respectively). Optic disc diminution correlated with disc shape change from a more circular to an elliptical shape (OR, 37.9; 95% confidence interval, 9.7-148.0; P < 0.001) and in all eyes with beta/gamma zone enlargement. Conclusions: Over the 10-year follow-up, >75% of highly myopic eyes showed progressive myopic changes of the optic nerve head and macula.
Institutions: Institut Français, Singapore National Eye Center, L V Prasad Eye Institute, Singapore Eye Research Institute, Fondation de Rothschild, Beijing Tsinghua Chang Gung Hospital, Tsinghua University, Heidelberg University, Beijing Tongren Hospital, Capital Medical University, University of Cologne, University Hospital Cologne
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,850
Award: G7948336518
OpenAlex ID: W4417304930