Progression of Myopic Maculopathy during 18-Year Follow-up

Purpose To examine the progression pattern of myopic maculopathy. Design Retrospective, observational case series. Participants Highly myopic patients who had been followed up for 10 years or more. Methods Using fundus photographs, myopic features were differentiated according to Meta-analysis of Pathologic Myopia (META-PM) Study Group recommendations. Main Outcome Measures Progression pattern of maculopathy. Results The study included 810 eyes of 432 patients (mean age, 42.3±16.8 years; mean axial length, 28.8±1.9 mm; mean follow-up, 18.7±7.1 years). The progression rate of myopic maculopathy was 47.0 per 1000 eye-years. Within the pathologic myopia (PM) group (n = 521 eyes), progression of myopic maculopathy was associated with female gender (odds ratio [OR], 2.21; P  = 0.001), older age (OR, 1.03; P  = 0.002), longer axial length (OR, 1.20; P  = 0.007), greater axial elongation (OR, 1.45; P  = 0.005), and development of parapapillary atrophy (PPA; OR, 3.14; P P Conclusions The most frequent progression patterns were an extension of peripapillary diffuse atrophy to macular diffuse atrophy in diffuse atrophy, enlargement of the original atrophic lesion in patchy atrophy, and development of patchy atrophy in LCs. Main risk factors for progression were older age, longer axial length, and development of PPA.