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  • Title: Progression of diffuse chorioretinal atrophy among patients with high myopia: a 4-year follow-up study.
    Author: Li Z, Liu R, Xiao O, Guo X, Zhang J, Wang D, Jong M, Sankaridurg P, Ohno-Matsui K, He M.
    Journal: Br J Ophthalmol; 2021 Jul; 105(7):989-994. PubMed ID: 32829302.
    Abstract:
    AIMS: To investigate the progression pattern of diffuse chorioretinal atrophy (DCA) among Chinese participants with high myopia. METHODS: This is a longitudinal, non-interventional study. Participants with high myopia, defined as ≤-6 diopters spherical power, were included and followed up for 4 years, and underwent cycloplegic autorefraction, best-corrected visual acuity (BCVA) and fundus photography examinations. Newly established DCA, enlargement of existing DCA and development of other lesions of myopic maculopathy were regarded as DCA progression. RESULTS: Of the 484 participants with a mean age of 21.5±12.7 years (range, 6.8-69.7 years), 68 eyes (14.0%) showed DCA progression, with 88 lesion changes. The first appearance of DCA was identified in 21 eyes (23.9%). Of 88 eyes with DCA at baseline, 47 eyes (53.4%) showed progression, with 67 lesion changes, including 45 eyes (67.2%) with enlargement of DCA, 17 (25.3%) with a first appearance of lacquer cracks, 4 (6.0%) with development of patchy chorioretinal atrophy and 1 (1.5%) with increased numbers of lacquer cracks. Longer axial length (p<0.001), baseline DCA (p=0.005) and baseline DCA closer to the fovea (p=0.013) predicted DCA progression. Eyes had poorer BCVA at the follow-up if DCA was enlarging (p<0.001) or DCA was closer to the fovea at baseline (p=0.028) after adjusting for age,gender and cataract. CONCLUSION: Approximately half of the participants with DCA had progression over a 4-year follow-up. Enlargement and newly developed DCA were common progression patterns. Larger areas of DCA and foveal involvement with DCA could be indicators of a worse BCVA later.
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