Fundus characteristics in teenagers with high myopia_Chinese Journal of Ocular Fundus Diseases

Authors：

Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China (Guo Yin, Tang Ping, Wu Min, Lyu Yanyun, Feng Yi); Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China (Guo Yin, Liu Lijuan, Xu Liang);

Corresponding author：

Keywords：

Myopia; degenerative/diagnosis; Myopia; degenerative/complications; Disease attributes

DOI：

10.3760/cma.j.issn.1005-1015.2016.06.015

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Objective To assess the fundus characteristics and their associations with refractive error, best corrected visual acuity (BCVA) of highly myopic eyes in Chinese teenagers. Methods This is a cross-sectional and retrospective study. 544 teenagers (1050 eyes) with refraction more than -6.00 D were recruited from Tongren Eye Care Center. All participants underwent examinations including cycloplegic auto-refractometry and retinoscopy, BCVA, slit lamp and 45℃olor funds photography centered in macular. BCVA was recorded with logarithm of the minimum angle of resolution (logMAR) acuity. 988/1050 (94.1%) fundus photographs with clearly visible optic disc and fovea were selected for analysis. Degree of tessellation in optic disc and macular was defined by the exposure of choroidal vessel. Area of beta parapapillary atrophy (PPA), maximal and minimal diameter of optic disc, degree of fundus tessellation were measured by Image J software. Optic disc ovality was calculated by maximal diameter/minimal diameter. Associations between degree of tessellation, beta PPA area, optic disc ovality and refractive error, BCVA were analyzed. Presence of high myopic retinopathy, including chorioretinal atrophy, lacquer crack and Fuchs spot were also observed. Results Mean spherical equivalent was (-10.66±2.63) D. Mean logMAR BCVA was 0.11±0.22. Tessellation was in 66.9% eyes. Mean degree in macular and peripapillary region was 0.83±0.96 and 1.04±1.00 (r=0.875, P=0.000). Beta PPA was in 97.3% eyes and mean area was (0.45±0.57) mm². Mean ovality factor was 1.25±0.18 and Tilted optic disc was in 28.5% eyes. Refractive error, logMAR BCVA, beta PPA area, tilted optic disc and ovality factor were related with the degree of optic disc and macular tessellation (P < 0.05). Highly myopic retinopathy was found in 28 eyes, with older age, larger area of PPA, higher presence of tilted optic disc and degree of tessellation, worse BCVA. Conclusions Beta PPA was the main fundus characteristics in teenagers. Visual acuity can be seriously impaired by highly myopic retinopathy, such as chorioretinal atrophy.

Citation： GuoYin, TangPing, WuMin, LyuYanyun, FengYi, LiuLijuan, XuLiang. Fundus characteristics in teenagers with high myopia. Chinese Journal of Ocular Fundus Diseases, 2016, 32(6): 628-632. doi: 10.3760/cma.j.issn.1005-1015.2016.06.015 Copy

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9.	Lin LL, Shih YF, Hsiao CK, et al. Prevalence of myopia in Taiwanese schoolchildren:1983 to 2000[J]. Ann Acad Med Singapore, 2004, 33(1):27-33.
10.	Sun J, Zhou JB, Zhao PQ, et al. High prevalence of myopia and high myopia in 5060 chinese university students in Shanghai[J]. Invest Ophthalmol Vis Sci, 2012, 53(12):7504-7509. DOI:10.1167/iovs.11-8343.
11.	Yan YN, Wang YX, Xu L, et al. Fundus tessellation:prevalence and associated factors:the Beijing Eye Study 2011[J]. Ophthalmolgy, 2015, 122(9):1873-1880. DOI:10.1016/j.ophtha.2015.05.031.
12.	Littmann H. Determination of the real size of an object on the fundus of the living eye[J]. Klin Monbl Augenbeilkd, 1982, 180(4):286-289.
13.	You QS, Xu L, Jonas JB. Tilted optic discs:the Beijing Eye Study[J]. Eye (Lond), 2008, 22(5):728-729. DOI:10.1038/eye.2008.87.
14.	Chen H, Wen F, Li H, et al. The types and severity of high myopic maculopathy in Chinese patients[J]. Ophthalmic Physil Opt, 2012, 32(1):60-67. DOI:10.1111/j.1475-1313.2011.00861.x.
15.	Yoshihara N, Yamashita T, Ohno-Matsui K, et al. Objective analyses of tessellated fundi and significant correlation between degree of tessellation and choroidal thickness in healthy eyes[J/OL]. PLoS One, 2014, 9(7):103586[2014-07-28]. DOI:10.1371/journal.pone.0103586.
16.	Guo Y, Liu LJ, Xu L, et al. Parapapillary beta zone in primary school children in Beijing:associations with outdoor activity[J]. Invest Ophthalmol Vis Sci, 2014, 55(2):918-925. DOI:10.1167/iovs.13-13502.
17.	Guo Y, Liu LJ, Xu L, et al. Optic disc ovality in primary school children in Beijing[J]. Invest Ophthalmol Vis Sci, 2015, 56(8):4547-4553. DOI:10.1167/iovs.15-16590.
18.	Wang Y, Xu L, Zhang L, et al. Peripapillary atrophy in elderly Chinese in rural and urban Beijing[J]. Eye (Lond), 2008, 22(2):261-266.
19.	Koh VT, Nah GK, Chang L, et al. Pathologic changes in highly myopic eyes of young males in Singapore[J]. Ann Acad Med Singapore, 2013, 42(5):216-224.
20.	Guo Y, Wang YX, Xu L, et al. Five year follow-up of parapapillary atrophy:the Beijing Eye Study[J/OL]. PLoS One, 2012, 7(5):32005[2012-05-07]. DOI:10.1371/journal.pone.0032005.

1. Chang L, Pan CW, Ohno-Matsui K, et al. Myopia-related fundus changes in Singapore adults with high myopia[J]. Am J Ophthalmol, 2013, 155(6):991-999. DOI:10.1016/j.ajo.2013.01.016.
2. Liu HH, Xu L, Wang YX, et al. Prevalence and progression of myopic retinopathy in Chinese adults:the Beijing Eye Study[J]. Ophthalmology, 2010, 117(9):1763-1768. DOI:10.1016/j.ophtha.2010.01.020.
3. Kyoko OM, Timothy YY, Chi CL, et al. Updates of pathologic myopia[J]. Prog Retin Eye Res, 2016, 52:156-187. DOI:10.1016/j.preteyeres.2015.12.001.
4. Xu L, Wang Y, Li Y, et al. Causes of blindness and visual impairment in urban and rural areas in Beijing:the Beijing Eye Study[J]. Ophthalmology, 2006, 113(7):1134-1141.
5. Morgan IG, Matsui OM, Saw SM. Myopia[J]. Lancet, 2012, 379(9827):1739-1748. DOI:10.1016/S0140-6736(12)60272-4.
6. 郭寅, 刘丽娟, 徐亮, 等.北京市城乡限定学校一、四年级小学生近视眼患病率及相关危险因素[J].眼科, 2012, 21(2):127-131.Guo Y, Liu LJ, Xu L, et al. The prevalence and associated risk factors of myopia in grade 1 and grade 4 primary students of defined schools in urban and rural regions of Beijing[J]. Ophthalmol CHN, 2012, 21(2):127-131.
7. You QS, Wu LJ, Duan JL, et al. Factors associated with myopia in school children in China:the Beijing Childhood Eye Study[J/OL]. PLoS One, 2012, 7(12):52668[2012-12-27]. http://dx.plos.org/10.1371/journal.pone.0052668. DOI:10.1371/journal.pone.0052668..
8. Wu LJ, You QS, Duan JL, et al. Prevalence and associated factors of myopia in high school students in Beijing[J/OL]. PLoS One, 2015, 10(3):0120764[2015-03-24]. http://dx.plos.org/10.1371/journal.pone.0120764. DOI:10.1371/journal.pone.0120764.
9. Lin LL, Shih YF, Hsiao CK, et al. Prevalence of myopia in Taiwanese schoolchildren:1983 to 2000[J]. Ann Acad Med Singapore, 2004, 33(1):27-33.
10. Sun J, Zhou JB, Zhao PQ, et al. High prevalence of myopia and high myopia in 5060 chinese university students in Shanghai[J]. Invest Ophthalmol Vis Sci, 2012, 53(12):7504-7509. DOI:10.1167/iovs.11-8343.
11. Yan YN, Wang YX, Xu L, et al. Fundus tessellation:prevalence and associated factors:the Beijing Eye Study 2011[J]. Ophthalmolgy, 2015, 122(9):1873-1880. DOI:10.1016/j.ophtha.2015.05.031.
12. Littmann H. Determination of the real size of an object on the fundus of the living eye[J]. Klin Monbl Augenbeilkd, 1982, 180(4):286-289.
13. You QS, Xu L, Jonas JB. Tilted optic discs:the Beijing Eye Study[J]. Eye (Lond), 2008, 22(5):728-729. DOI:10.1038/eye.2008.87.
14. Chen H, Wen F, Li H, et al. The types and severity of high myopic maculopathy in Chinese patients[J]. Ophthalmic Physil Opt, 2012, 32(1):60-67. DOI:10.1111/j.1475-1313.2011.00861.x.
15. Yoshihara N, Yamashita T, Ohno-Matsui K, et al. Objective analyses of tessellated fundi and significant correlation between degree of tessellation and choroidal thickness in healthy eyes[J/OL]. PLoS One, 2014, 9(7):103586[2014-07-28]. DOI:10.1371/journal.pone.0103586.
16. Guo Y, Liu LJ, Xu L, et al. Parapapillary beta zone in primary school children in Beijing:associations with outdoor activity[J]. Invest Ophthalmol Vis Sci, 2014, 55(2):918-925. DOI:10.1167/iovs.13-13502.
17. Guo Y, Liu LJ, Xu L, et al. Optic disc ovality in primary school children in Beijing[J]. Invest Ophthalmol Vis Sci, 2015, 56(8):4547-4553. DOI:10.1167/iovs.15-16590.
18. Wang Y, Xu L, Zhang L, et al. Peripapillary atrophy in elderly Chinese in rural and urban Beijing[J]. Eye (Lond), 2008, 22(2):261-266.
19. Koh VT, Nah GK, Chang L, et al. Pathologic changes in highly myopic eyes of young males in Singapore[J]. Ann Acad Med Singapore, 2013, 42(5):216-224.
20. Guo Y, Wang YX, Xu L, et al. Five year follow-up of parapapillary atrophy:the Beijing Eye Study[J/OL]. PLoS One, 2012, 7(5):32005[2012-05-07]. DOI:10.1371/journal.pone.0032005.

Chinese Journal of Ocular Fundus Diseases

Fundus characteristics in teenagers with high myopia

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