AUTHOR=Tey Kai Yuan , Hoang Quan V. , Loh Isabella Q. , Dan Yee Shan , Wong Qiu Ying , Yu Daryle Jason G. , Yandri Vivi R. , Ang Marcus , Cheung Gemmy C. M. , Lee Shu Yen , Wong Tien Yin ,  SNEC Retina Group , Chong Rachel S. , Wong Chee Wai , Cheng Anna , Tan Sim , Fenner Beau James , Chan Choi Mun , Yeo Ian Yew San , Teo Kelvin Yi Chong , Mathur Ranjana , Sim Shaun Sebastian , Shaan Wiryasaputra , Tsai Andrew Shih Hsiang , Ang Chong Lye , Cheung Ning , Daniel Ting Shu Wei , Wong Doric Wen Kuan , Wong Edmund Yick Mun , Tan Gavin Siew Wei , Rim Hyungtaek 

TITLE=Multimodal Imaging-Based Phenotyping of a Singaporean Hospital-Based Cohort of High Myopia Patients

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.670229

DOI=10.3389/fmed.2021.670229

ISSN=2296-858X

ABSTRACT=<p><bold>Purpose:</bold> To assess the effect of axial length (AL) on the prevalence of pathologic myopia (PM) and associated myopic features in a Singaporean hospital-based cohort of patient with high myopia (HM).</p><p><bold>Methods:</bold> In total, 923 HM eyes from 495 individuals were recruited from the Myopic and Pathologic Eyes in Singapore (MyoPES) cohort and underwent ocular biometry, fundus photography, fundus autofluorescence, and swept-source optical coherence tomography (SS-OCT). Images were analyzed for the presence of myopic macular degeneration (MMD), myopic choroidal neovascularization (mCNV), myopic traction maculopathy (MTM), peripapillary atrophy (PPA), myopic tilted disc, posterior staphyloma (PS), dome-shaped macula (DSM), vitremacular adhesions (VMA), and the epiretinal membrane (ERM). Eyes were stratified into quartiles based on ALs to determine cut-off values to perform comparisons between shorter-length and longer-length groups. A χ<sup>2</sup>-test was done to determine the difference in the prevalence of pathologies between groups.</p><p><bold>Results:</bold> Overall, mean AL was 29.2 ± 2.2 mm (range 25.0–36.7 mm). Myopic macular degeneration, PPA, myopic tilted disc, and ERM have AL threshold of ≥27.5 mm, whereas MTM has an AL threshold of ≥29.0 mm. We found that there was a significantly higher prevalence of MMD (88.2 vs. 49.4%; <italic>p</italic> &lt; 0.001), PPA (98.1 vs. 80.1%; <italic>p</italic> &lt; 0.001), myopic tilted disc (72.7 vs. 50.2%; <italic>p</italic> &lt; 0.001), and ERM (81.4 vs. 17.3%; <italic>p</italic> = 0.003) in eyes with AL ≥ 27.5 mm vs. eyes without AL &lt;27.5 mm. Prevalence of MTM (34.7 vs. 32.1%; <italic>p</italic> &lt; 0.001), mCNV (17.4 vs. 12.1%; <italic>p</italic> = 0.03), PS (43.4 vs. 34.7%; <italic>p</italic> = 0.012), DSM (21.3 vs. 13.2%; <italic>p</italic> = 0.002), and VMA (5.9 vs. 2.6%; <italic>p</italic> = 0.014) in eyes with AL ≥ 29.0 mm compared with AL &lt; 29.0 mm.</p><p><bold>Conclusion:</bold> Our study describes the overall prevalence of PM and related pathologies among patients with HM in our hospital-based cohort. Longer eyes even among HM eyes had a significantly higher prevalence of PM-associated pathologies studied. This supports the premise that eyes with longer AL, even among HM eyes may be at greater risk of vision-threatening changes and therefore merit regular follow-up.</p>