Natural course of myopic traction maculopathy and factors influencing progression and visual acuity

BMC Ophthalmol. 2021 Sep 25;21(1):347. doi: 10.1186/s12886-021-02087-y.

Abstract

Background: To describe the natural course of myopic traction maculopathy (MTM) and determine predictive factors for its progression and visual prognosis.

Methods: This retrospective observational study included 113 MTM patients (113 eyes). Best-corrected visual acuity (BCVA) measurements and optical coherence tomography findings were recorded.

Results: Over a mean follow-up of 38.2 ± 11.1 months, 49 of 113 eyes (43.4 %) progressed. The progression rate of outer schisis prominently located in the fovea or posterior staphyloma was significantly higher than that of outer schisis prominently located in paravascular areas (P = 0.0011). MTM with partial posterior vitreous detachment during the follow-up progressed more rapidly than MTM without (P = 0.0447). Patients with older age (> 65 years), without domed-shaped macula and with defects in the ellipsoid zone (EZ) had worse BCVA at the last visit (P = 0.0416, P = 0.0494and P = 0.0130). Multiple linear regression analysis showed that BCVA and defects in the EZ at baseline were significantly associated with the final BCVA (P < 0.0001 and P = < 0.0001, respectively).

Conclusions: MTM has a high possibility for progression. Outer schisis located predominantly in the fovea or posterior staphyloma or with partial posterior vitreous detachment exhibits rapid progression. The integrity of the EZ is related to visual prognosis.

Keywords: High myopia; Myopic traction maculopathy; Natural course; Optical coherence tomography; Visual acuity.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Follow-Up Studies
  • Humans
  • Macula Lutea*
  • Macular Degeneration*
  • Middle Aged
  • Myopia, Degenerative* / diagnosis
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Traction
  • Visual Acuity