UPmémoires

English

Objective: Refractive errors (RE), particularly myopia, are the first cause of visual impairment worldwide. High myopia is a frequent cause of sight-threatening chorioretinal complications. This study aimed to evaluate the prevalence of retinal complications in patients suffering from myopia.

Methods: This cross-sectional study was carried out in French eye clinics mainly dedicated to refractive errors. Data collection included age, gender, refractive subjective errors on both eyes and any relevant ocular history related to retinal complications of myopia documented with fundus examination, SD-OCT or fluorescein angiography. Myopia was defined as mild (-0.5 to -3D), moderate (-3 to -6 D), high (-6 to -10D) and very high (less than -10D). Macular complications related to myopia included staphyloma, lacker cracks (LC), myopic choroidal neovascularization (mCNV), chorioretinal atrophy (CRA) and retinoschisis.

Results: medical data files from 198 641 myopic individuals (55.8% of women) with a mean age of 34 years (SD: 15 years) were analyzed. Prevalence of mild, moderate, high and very high myopia was respectively 65.95%, 26.14%, 6.72% and 1.19%. Prevalences of retinal complications in the high and very high myopia groups were respectively: for staphyloma 2.01% [1.78 - 2.27%] and 7.65% [6.61 - 8.80%]; for LC 0.07% [0.03 - 0.13%] and 0.51% [0.26 - 0.88%]; for mCNV 0.07% (0.03 - 0.13%) and 0.42% (0.20 - 0.78%) in the high and very high myopia groups; for retinoschisis 0.03% [0.01 - 0.08%] and 0.30% [0.12 - 0.61%]; for macular CRA 0.39% [0.29 - 0.51] and 3.42% [2.73 - 4.24]. After adjustment on myopia and age, the risk for CRA was higher among women: OR=1.33; 95% CI [1.01 – 1.75]. Prevalence of blindness or visual impairment was observed in 29.95% [28.10 – 31.85%] of very high myopic patients. At 60 years old or over, the frequencies of blindness or visual impairment were respectively of 27.19% [24.35 – 30.19%] and 56.74% [51.10 – 62.25%] in the high and very high myopia groups.

Conclusions: This multicentric study provides new insights in terms of prevalence of retinal complications related to myopia. This is to our knowledge, one of the largest European ophthalmological series of individuals dedicated to prevalences of retinal complications of myopia.