Elsevier

Ophthalmology

Volume 117, Issue 9, September 2010, Pages 1763-1768
Ophthalmology

Original article
Prevalence and Progression of Myopic Retinopathy in Chinese Adults: The Beijing Eye Study

https://doi.org/10.1016/j.ophtha.2010.01.020Get rights and content

Purpose

To determine the prevalence and progression of myopic retinopathy in Chinese adults.

Design

Population-based cross-sectional study.

Participants

The Beijing Eye Study 2001 included 4439 subjects of 5324 individuals who were invited to participate (response rate, 83.4%); the eligibility criterion was an age of 40+ years. The study was repeated in 2006, with 3251 subjects (73.2%) participating.

Methods

The participants underwent a detailed eye examination, including fundus photography. Myopic retinopathy was defined by posterior staphylomata, lacquer cracks, Fuchs' spot of the macula, and myopic chorioretinal atrophy at the posterior pole. Parapapillary atrophy was assessed separately.

Main Outcome Measures

Prevalence of myopic retinopathy and its change during a follow-up of 5 years.

Results

After exclusion of pseudophakic or aphakic eyes, and eyes without assessable fundus photographs, 4319 subjects (97.3%) were included in the present study. Myopic retinopathy was present in 198 eyes (2.3%±0.2%; 95% confidence interval [CI], 2.0–2.6) of 132 participants (3.1%). Myopic retinopathy was significantly associated with higher age (P<0.001), worse best-corrected visual acuity (P<0.001), deeper anterior chamber (P = 0.04), larger optic disc (P<0.001), less age-related macular degeneration (P = 0.02; odds ratio [OR] 0.90), and greater prevalence of open-angle glaucoma (P<0.001; OR 4.42). Myopic retinopathy was not associated significantly (P>0.20) with body height and weight, gender, rural versus urban region of residence, level of education, intraocular pressure, or central corneal thickness. The prevalence of myopic retinopathy increased significantly (P<0.001) with increasing myopic refractive error, from 3.8% in eyes with a myopic refractive error of < −4.0 diopters to 89.6% in eyes with a myopic refractive error of at least −10.0 diopters. At the 5-year follow-up examination, enlargement of the chorioretinal atrophy at the posterior fundus was observed in 9% of the eyes.

Conclusions

Myopic retinopathy was present in 3.1% of subjects aged 40+ years who resided in the Greater Beijing area. Myopic retinopathy was associated with increased age, worse best-corrected visual acuity, deeper anterior chamber, larger optic disc, less age-related macular degeneration, and higher prevalence of open-angle glaucoma.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found after the references.

Section snippets

Materials and Methods

The Beijing Eye Study is a population-based prospective cohort study in Greater Beijing. Of 5324 individuals with an age of 40+ years who were eligible, 4439 individuals participated in the baseline study in 2001 (response rate, 83.4%). The mean age was 56.0±10.4 years (range, 40–101 years). In 2006, the study was repeated by inviting all participants from the survey of 2001; 3251 subjects (73.2%) of the 4439 participants of the 2001 study took part. The study was divided into a rural part

Results

Of the 4439 individuals, readable fundus photographs and data on the refractive error were available on 4342 (97.8%). All aphakic and pseudophakic eyes were excluded, so 4319 participants (97.3%; 8484 eyes) remained. On the basis of the questionnaire administered to all study participants, none of those included had undergone refractive surgery. Myopia, which was defined as a myopic spherical equivalent of > −0.50 diopters (D), was present in at least 1 eye of 1191 participants (1980 eyes).

Discussion

Myopic retinopathy, which was found in 2.3%±0.2% of the eyes included in the study, was associated significantly with higher age (P<0.001), worse best-corrected visual acuity (P<0.001), deeper anterior chamber (P = 0.04), larger optic disc (P<0.001), lower prevalence of age-related macular degeneration (P = 0.02; OR 0.90), and greater prevalence of open-angle glaucoma (P<0.001; OR 4.42). The presence of myopic retinopathy was not associated significantly (P>0.20) with body height and weight,

Study Limitations

Potential limitations of our study should be mentioned. The major concern, and a problem inherent to any epidemiologic study, is nonparticipation. The Beijing Eye Study 2006 had a reasonable response rate of approximately 73%, 3251 of the 4439 subjects invited for the follow-up survey (or 61% of the group originally eligible in 2001); however, differences between participants and nonparticipants may have led to a selection artifact and produced bias in the prevalence rates of myopic

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    Manuscript no. 2009-1173.

    Financial Disclosure(s): The author(s) have made the following disclosure(s): Jost B. Jonas: Consultant for Allergan Inc.; Merck & Co., Inc.; Pfizer Inc.; CellMed AG, Alzenau, Germany; Morphosys AG, Munich, Germany; SOOFT SpA Montegiorgio, Italy; Patent holder with CellMed AG, Alzenau, Germany.

    Funded with a grant from the National Key Laboratory Fund, Beijing, China.

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