Prevalence and risk factors of myopic macular degeneration: the Aier-SERI high myopia adult cohort

Purpose To assess the prevalence and risk factors of myopic macular degeneration (MMD) in young and middle-aged individuals with high myopia in Changsha, central China. Methods A total of 445 adults with high myopia (worse than or equal to −5.0 D) were examined between 2021 and 2023. Autorefraction and biometry using IOLMaster were conducted, and fundus photos were graded for MMD using Meta-PM criteria. MMD was diagnosed if category 2, 3, 4 or any plus lesion was present. Risk factors such as age, gender, spherical equivalent (SE)/axial length (AL), body mass index, education and residence were analysed via logistic regression. Results Participants had an average age of 42.3±7.3 years. MMD prevalence was 21.8% (71 adults) with a mean SE of −9.5±4.7 D and AL of 27.3±1.9 mm. Significant risk factors included greater myopic SE (OR=1.7 per 1 D decrease) and longer AL (OR=3.6 per 1 mm increase). MMD prevalence rose sharply with myopia worse than −10.00 D and AL >27.00 mm, reaching up to 100% for myopia worse than −14.00 D or AL ≥29.00 mm. Conclusion MMD affects about one in five young to middle-aged adults with high myopia. Those exceeding critical myopia and AL thresholds are at higher risk and should be closely monitored. Further research on interventions to prevent axial elongation is needed, particularly for those with high genetic risk.