Prevalence of myopic macular degeneration exceeds 75% among highly myopic older adults
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Key takeaways:
- Prevalence of myopic macular degeneration increased 8.89-fold for each millimeter increase in axial length.
- Vision impairment and blindness also were associated with prevalence of myopic macular degeneration.
The prevalence of myopic macular degeneration among very old individuals increased nearly ninefold for each millimeter increase in axial length and was strongly associated with vision impairment and blindness, according to a study.
“Myopic macular degeneration (MMD) has become one of the most common causes for irreversible vision impairment and blindness in the adult population worldwide, and in particular in East and Southeast Asia,” Mukharram M. Bikbov, MD, PhD, director of Ufa Eye Research Institute, and colleagues wrote in Investigative Ophthalmology & Visual Science. “Considering that older age is one of the risk factors for the development of MMD, it has been discussed that, as this young myopic generation gets older, the role of MMD as a cause of vision impairment and blindness may increase even further.”
To examine the prevalence of MMD in older individuals, Bikbov and colleagues conducted the population-based Ural Very Old Study of 1,526 individuals aged 85 years and older (25.6% men) in the Russian Republic of Bashkortostan. Researchers interviewed participants in their homes to obtain demographics and medical history and conducted physical and ophthalmological exams in a hospital setting. Participants who were unable to access a hospital had assessments performed in their homes using portable devices.
According to results, 105 individuals completed the home interview but died before they could receive an exam, 246 did not receive an exam in the hospital or at home, 423 did not go to the hospital but were examined in their homes, and 751 were examined in the hospital.
Of the 1,174 participants who received an exam at the hospital or in their homes, 930 had assessable fundus images, and 21 of those had MMD, with 10 participants at stage 3 and 11 at stage 4 disease.
Advancing stage of MMD was associated with significantly worse best corrected visual acuity. In participants without MMD, the BCVA was 0.52 ± 0.46 logMAR, while those with stage 3 MMD had a BCVA of 1.68 ± 3.3 logMAR, and those at stage 4 had a BCVA of 1.76 ± 2.79 logMAR.
Among those with stages 3 and 4 MMD, the prevalence of binocular moderate to severe vision impairment was 40% and 64%, respectively, and the prevalence of binocular blindness was 20% and 27%.
Among individuals with minor myopia, the prevalence of MDD was 0% for right eyes and 2% for left eyes. In the moderately myopic group, MMD prevalence increased to 8% and 11%, respectively, while in the highly myopic group, it increased to 78% and 75%, respectively.
“MMD prevalence was strongly associated with vision impairment and blindness,” Bikbov and colleagues wrote. “Its prevalence increased 8.89-fold for each millimeter increase in axial length, leading to a prevalence of approximately 75% in the highly myopic group of our elderly study population.”
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