Correlation Between Atrophic Myopic Maculopathy And Choroid Thickness In High Myopia Patients

Objective: Measure the choroidal thickness of atrophic myopic maculopathy in h igh myopia patients by using enhanced depth imaging spectral domain optical co herence tomography(EDI-OCT),and explore the effects of choroidal thickness,a ge,sex,diopter,intraocular pressure and axial length on myopic maculopathy.R eceiver Operating Characteristic(ROC)analyses were performed to determine the cut-off values,such as choroidal thickness and other factors for the development of non-pathological myopia to pathological myopia.The effects of age,sex,diop ter,intraocular pressure and axis length on choroidal thickness were also investi gated.Methods: In this cross-sectional study,high myopia patients(102 subjects 102 ey es)who went to the ophthalmology department of the first affiliated hospital of Dalian Medical University from December 2017 to December 2019 were include d,atrophic myopic maculopathy was classified into C0-C4 categories,C0 is no m yopic maculopathy,C1 is tessllated fundus,C2 is diffuse chorioretinal atrophy,C3 i s patchy chorioretinal atrophy,C4 is macular atrophy.Pathologic myopia was defi ned as the presence of myopic maculopathy equal to or more severe than C2(dif fuse chorioretinal atrophy).C0(16 subjects 16 eyes),C1(30 subjects 30 eyes),C2(28 subjects 28 eyes),C3(21 subjects 21 eyes),C4(7 subjects 7 eyes).Record patient's age and sex,and measure diopter(Spherical Equivalent,SE),best correcte d visual acuity(Logarithm ofthe Minimum Angle of Resolution,Log MAR),intrao cular pressure(IOP)and axis length(AL).Measure the subfoveal choroidal thickne ss(SFCT)and the choroidal thickness of superior,inferior,nasal,temporal 1.5mm from fovea.Using spss22.0 statistic software to analyze data,the difference was regarded as statistically significant when p<0.05.Results:1.The severity of atrophic myopic maculopathy was affected by the subfoveal c horoid thickness,age,axis length and diopter.Age and axis length are are the r isk factors for atrophic myopic maculopathy,and subfoveal choroidal thickness a nd diopter are the protective factors for atrophic myopic maculopathy.For each1 year increase in age,the probability of the lesion degree being at least one gra de higher was 1.053 times(OR age =1.503,p<0.05).For each 1mm increase in axis length,the probability of the lesion degree being at least one grade higher was 1.721 times(OR AL =1.721,p<0.05).For each 1?m reduction in subfoveal choroid thickness,the probability of the lesion degree being at least one grade h igher was 0.980 times(OR SFCT=0.980,p<0.05).For each 1D reduction in diopt er,the probability of the lesion degree being at least one grade higher was 0.886 times(OR diopter =0.886,p<0.05).The severity of atrophic myopic macular lesi ons was not affected by para-fovea choroidal thickness,intraocular pressure and sex(P>0.05).2.The cut-off value of the subfoveal choroidal thickness for progression from n on-pathological myopia(stage C0 and C1)to pathological myopia(equal or abo ve stage C2)was 112.75?m,the cut-off age was 58 years old,axial length was28.31 mm,and diopter was-9.313 D.3.Subfoveal choroidal thickness(SFCT)was affected by age,axis length and dio pter,the axial and age were negatively correlated with SFCT(?AL =-0.467,t=-5.729,P<0.05),?age =-0.248,t=-3.423,P<0.05),diopter was positively correlated with SFCT(?diopter =0.231,t=2.765,P<0.05),axis length had the greatest influen ce on SFCT,followed by age and finally diopter.Intraocular pressure and sex w ere were not correlated with SFCT(P>0.05).Conclusions:The severity of atrophic maculopathy was affected by subfoveal ch oroidal thickness,age,axis length and diopter.The subfoveal choroidal thicknesswas negatively correlated with age and axis length,and positively correlated with diopter.The cut-off values can be used as predictive references for the develop ment of non-pathological myopia to pathological myopia.