Factors associated with pathologic myopia onset and progression: A systematic review and meta‐analysis.

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Title: Factors associated with pathologic myopia onset and progression: A systematic review and meta‐analysis.
Authors: Yii, Fabian (AUTHOR), Nguyen, Linda (AUTHOR), Strang, Niall (AUTHOR), Bernabeu, Miguel O. (AUTHOR), Tatham, Andrew J. (AUTHOR), MacGillivray, Tom (AUTHOR), Dhillon, Baljean (AUTHOR)
Source: Ophthalmic & Physiological Optics. Jul2024, Vol. 44 Issue 5, p963-976. 14p.
Subjects: Myopia, Pathologic neovascularization, Intraocular pressure, Macular degeneration, Odds ratio, Prognosis, Longitudinal method
Geographic Terms: Asia
Abstract: Purpose: To synthesise evidence across studies on factors associated with pathologic myopia (PM) onset and progression based on the META‐analysis for Pathologic Myopia (META‐PM) classification framework. Methods: Findings from six longitudinal studies (5–18 years) were narratively synthesised and meta‐analysed, using odds ratio (OR) as the common measure of association. All studies adjusted for baseline myopia, age and sex at a minimum. The quality of evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation framework. Results: Five out of six studies were conducted in Asia. There was inconclusive evidence of an independent effect (or lack thereof) of ethnicity and sex on PM onset/progression. The odds of PM onset increased with greater axial length (pooled OR: 2.03; 95% CI: 1.71–2.40; p < 0.001), older age (pooled OR: 1.07; 1.05–1.09; p < 0.001) and more negative spherical equivalent refraction, SER (OR: 0.77; 0.68–0.87; p < 0.001), all of which were supported by an acceptable level of evidence. Fundus tessellation was found to independently increase the odds of PM onset in a population‐based study (OR: 3.02; 2.58–3.53; p < 0.001), although this was only supported by weak evidence. There was acceptable evidence that greater axial length (pooled OR: 1.23; 1.09–1.39; p < 0.001), more negative SER (pooled OR: 0.87; 0.83–0.92; p < 0.001) and higher education level (pooled OR: 3.17; 1.36–7.35; p < 0.01) increased the odds of PM progression. Other baseline factors found to be associated with PM progression but currently supported by weak evidence included age (pooled OR: 1.01), severity of myopic maculopathy (OR: 3.61), intraocular pressure (OR: 1.62) and hypertension (OR: 0.21). Conclusions: Most PM risk/prognostic factors are not supported by an adequate evidence base at present (an indication that PM remains understudied). Current factors for which an acceptable level of evidence exists (limited in number) are unmodifiable in adults and lack personalised information. More longitudinal studies focusing on uncovering modifiable factors and imaging biomarkers are warranted. [ABSTRACT FROM AUTHOR]
Copyright of Ophthalmic & Physiological Optics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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Items – Name: Title
  Label: Title
  Group: Ti
  Data: Factors associated with pathologic myopia onset and progression: A systematic review and meta‐analysis.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Yii%2C+Fabian%22&quot;&gt;Yii, Fabian&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Nguyen%2C+Linda%22&quot;&gt;Nguyen, Linda&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Strang%2C+Niall%22&quot;&gt;Strang, Niall&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bernabeu%2C+Miguel+O%2E%22&quot;&gt;Bernabeu, Miguel O.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tatham%2C+Andrew+J%2E%22&quot;&gt;Tatham, Andrew J.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22MacGillivray%2C+Tom%22&quot;&gt;MacGillivray, Tom&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Dhillon%2C+Baljean%22&quot;&gt;Dhillon, Baljean&lt;/searchLink&gt; (AUTHOR)
– Name: TitleSource
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Ophthalmic+%26+Physiological+Optics%22&quot;&gt;Ophthalmic &amp; Physiological Optics&lt;/searchLink&gt;. Jul2024, Vol. 44 Issue 5, p963-976. 14p.
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  Label: Subjects
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Myopia%22&quot;&gt;Myopia&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Pathologic+neovascularization%22&quot;&gt;Pathologic neovascularization&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Intraocular+pressure%22&quot;&gt;Intraocular pressure&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Macular+degeneration%22&quot;&gt;Macular degeneration&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Odds+ratio%22&quot;&gt;Odds ratio&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Prognosis%22&quot;&gt;Prognosis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Longitudinal+method%22&quot;&gt;Longitudinal method&lt;/searchLink&gt;
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Asia%22&quot;&gt;Asia&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: To synthesise evidence across studies on factors associated with pathologic myopia (PM) onset and progression based on the META‐analysis for Pathologic Myopia (META‐PM) classification framework. Methods: Findings from six longitudinal studies (5–18 years) were narratively synthesised and meta‐analysed, using odds ratio (OR) as the common measure of association. All studies adjusted for baseline myopia, age and sex at a minimum. The quality of evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation framework. Results: Five out of six studies were conducted in Asia. There was inconclusive evidence of an independent effect (or lack thereof) of ethnicity and sex on PM onset/progression. The odds of PM onset increased with greater axial length (pooled OR: 2.03; 95% CI: 1.71–2.40; p &lt; 0.001), older age (pooled OR: 1.07; 1.05–1.09; p &lt; 0.001) and more negative spherical equivalent refraction, SER (OR: 0.77; 0.68–0.87; p &lt; 0.001), all of which were supported by an acceptable level of evidence. Fundus tessellation was found to independently increase the odds of PM onset in a population‐based study (OR: 3.02; 2.58–3.53; p &lt; 0.001), although this was only supported by weak evidence. There was acceptable evidence that greater axial length (pooled OR: 1.23; 1.09–1.39; p &lt; 0.001), more negative SER (pooled OR: 0.87; 0.83–0.92; p &lt; 0.001) and higher education level (pooled OR: 3.17; 1.36–7.35; p &lt; 0.01) increased the odds of PM progression. Other baseline factors found to be associated with PM progression but currently supported by weak evidence included age (pooled OR: 1.01), severity of myopic maculopathy (OR: 3.61), intraocular pressure (OR: 1.62) and hypertension (OR: 0.21). Conclusions: Most PM risk/prognostic factors are not supported by an adequate evidence base at present (an indication that PM remains understudied). Current factors for which an acceptable level of evidence exists (limited in number) are unmodifiable in adults and lack personalised information. More longitudinal studies focusing on uncovering modifiable factors and imaging biomarkers are warranted. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of Ophthalmic &amp; Physiological Optics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/opo.13312
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 14
        StartPage: 963
    Subjects:
      – SubjectFull: Myopia
        Type: general
      – SubjectFull: Pathologic neovascularization
        Type: general
      – SubjectFull: Intraocular pressure
        Type: general
      – SubjectFull: Macular degeneration
        Type: general
      – SubjectFull: Odds ratio
        Type: general
      – SubjectFull: Prognosis
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Asia
        Type: general
    Titles:
      – TitleFull: Factors associated with pathologic myopia onset and progression: A systematic review and meta‐analysis.
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            NameFull: Yii, Fabian
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            NameFull: Nguyen, Linda
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            NameFull: Strang, Niall
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            NameFull: Bernabeu, Miguel O.
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            – D: 01
              M: 07
              Text: Jul2024
              Type: published
              Y: 2024
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              Value: 02755408
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