Association between axial length and myopic maculopathy: the Hisayama Study

Abstract Purpose To assess the association between axial length and the prevalence of myopic maculopathy in a general Japanese population. Design Population-based cross-sectional study. Participants A total of 2,790 Hisayama residents aged 40 years or older, who consented to participate and had available data of axial length and fundus photographs in the right eyes, were enrolled in this study. Methods Myopic maculopathy was defined as the presence of diffuse chorioretinal atrophy, patchy chorioretinal atrophy, or macular degeneration. The optimal cut-off values of axial length for identifying myopic maculopathy were estimated from the receiver operating characteristic curve (ROC). The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a logistic regression analysis. Main Outcome Measures ORs of axial length for prevalent myopic maculopathy and the optimal cut-off values of axial length for detecting myopic maculopathy. Results Longer axial length was significantly associated with prevalence of myopic maculopathy in both sexes. The optimal cut-off values of axial length for identifying myopic maculopathy were 25.9 mm in men and 25.3 mm in women. Subjects with axial length of these values or longer had a significantly higher OR for myopic maculopathy than those with axial length below these values (OR [95% CI]: 21.23 [8.74-51.57] in men; 38.49 [18.03-86.49] in women). Conclusions The present study found that there was a positive association between axial length and the likelihood of myopic maculopathy, and the cut-off levels of axial length for identifying myopic maculopathy were 25.9 mm in men and 25.3 mm in women. Our findings suggest that patients with axial length close to or longer than these values should undergo intensive treatment and detailed ophthalmic follow-up.