Progression of diffuse chorioretinal atrophy among patients with high myopia: a 4-year follow-up study. Issue 7 (22nd August 2020)

• Record Type: Journal Article
• Authors: Li, Zhixi; Liu, Ran; Xiao, Ou; Guo, Xinxing; Zhang, Jian; Wang, Decai; Jong, Monica; Sankaridurg, Padmaja; Ohno-Matsui, Kyoko; He, Mingguang
• Is Part Of: British journal of ophthalmology. Volume 105:Issue 7(2021)
• Page Start: 989
• Page End: 994
• Publication Date: 2020-08-22
• Subjects: Retina -- Epidemiology -- Optics and Refraction; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2020-316691
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Aims: To investigate the progression pattern of diffuse chorioretinal atrophy (DCA) among Chinese participants with high myopia. Methods: This is a longitudinal, non-interventional study. Participants with high myopia, defined as ≤−6 diopters spherical power, were included and followed up for 4 years, and underwent cycloplegic autorefraction, best-corrected visual acuity (BCVA) and fundus photography examinations. Newly established DCA, enlargement of existing DCA and development of other lesions of myopic maculopathy were regarded as DCA progression. Results: Of the 484 participants with a mean age of 21.5±12.7 years (range, 6.8–69.7 years), 68 eyes (14.0%) showed DCA progression, with 88 lesion changes. The first appearance of DCA was identified in 21 eyes (23.9%). Of 88 eyes with DCA at baseline, 47 eyes (53.4%) showed progression, with 67 lesion changes, including 45 eyes (67.2%) with enlargement of DCA, 17 (25.3%) with a first appearance of lacquer cracks, 4 (6.0%) with development of patchy chorioretinal atrophy and 1 (1.5%) with increased numbers of lacquer cracks. Longer axial length (p<0.001), baseline DCA (p=0.005) and baseline DCA closer to the fovea (p=0.013) predicted DCA progression. Eyes had poorer BCVA at the follow-up if DCA was enlarging (p<0.001) or DCA was closer to the fovea at baseline (p=0.028) after adjusting for age, gender and cataract. Conclusion: Approximately half of the participants with DCA had progression over a 4-year follow-up. Enlargement and newly developed DCA were common progression patterns. Larger areas of DCA and foveal involvement with DCA could be indicators of a worse BCVA later.