Prevalence and characteristics of myopic retinopathy in a rural Chinese adult population: The Handan Eye Study

Objective: To determine the prevalence, characteristics, and risk factors for myopic retinopathy in a rural population in Northern China. Methods: The Handan Eye Study is a population-based study of eye disease in rural Chinese individuals 30 years or older. Eligible residents underwent a detailed ophthalmic examination including standardized visual acuity tests and retinal photography after pupil dilation. Myopic retinopathy was defined to include signs of staphyloma, lacquer cracks, Fuchs spot, and myopic chorioretinal atrophy. Results: Of the 6830 participants, 6603 (96.7%) had gradable photographs in at least 1 eye for assessment of myopic retinopathy. The mean (SD) age was 51.9 (11.8) years. Myopic retinopathy was observed in 60 participants (84 eyes), a person-specific prevalence of 0.9% (95% confidence interval, 0.7%-1.1%). Twenty-four (40.0%) had bilateral disease. Higher myopic retinopathy prevalencewas associated with older age (P<.001) and increasing myopic spherical equivalent refractive error (P<.001). Mean (SD) spherical equivalent refraction was -12.3 (6.1) diopters for eyes with myopic retinopathy compared with -1.6 (1.6) diopters in myopic eyes without myopic retinopathy (P<.001). Bilateral blindness or low vision as defined by best-corrected visual acuity was present in 14 participants (24.6%) with myopic retinopathy. Staphyloma was the most frequent myopic retinopathy sign (86.9%), followed by chorioretinal atrophy (56.0%), lacquer cracks (36.9%), and Fuchs spot (14.3%). Conclusions: Myopic retinopathy was detected in 0.9% of rural Chinese individuals 30 years or older. The prevalence of myopic retinopathy was lower than that in the Beijing Eye Study but was similar to white individuals of similar age in the Australian Blue Mountains Eye Study.