Characteristics And Risk Factors Of Myopic Fundus Tessellation In Young Adults

Section 1 Characteristics and risk factors of myopic fundus tessellation in university students?Purpose? To explore the characteristics of retinal thickness(Re T),choroidal thickness(Ch T)and subfoveal scleral thickness(SST)changes in occurrence and exacerbation of myopic fundus tessellation during early stage of pathological myopia in university students.?Methods? Cross-sectional study.A total of 660 right eyes of 660 university students were included in the study.Participants underwent comprehensive ophthalmic examinations,including swept-source optical coherence tomography(SS-OCT).The topographic variation and factors,tilted disc ratio,parapapillary atrophy(PPA),Re T,macular choroidal thickness(m Ch T),peripapillary choroidal thickness(p Ch T)and SST related to fundus tessellation were measured.Participants were divided into normal fundus group and tessellated fundus group,and the differences of systematic and ophthalmic factors were compared between two groups.Then participants were divides into four groups according to the severity of fundus tessellation,risk factors of the severity of fundus tessellation were analyzed,and choroidal thickness in macular and peripapillary region were measured and compared among these four groups.? Results ? Macular and disc tessellated fundus had lower spherical equivalent(p<0.0001),lower best corrected visual acuity(p=0.03),more likely to have tilted disc(p<0.0001),larger peripapillary atrophy(PPA),thinner retina(p< 0.0001),and a significantly thinner choroid in all regions analyzed(p< 0.0001).Macular tessellated fundus also had a significantly thinner sclera.A higher degree of macular fundus tessellation was strongly associated with longer axial length(AL)(p<0.0001),tilted disc(p=0.014),larger PPA(p<0.0001),m Ch T(p< 0.0001)and SST(p< 0.0001),while a higher degree of peripapillary fundus tessellation was significantly associated with longer AL(p<0.0001),larger PPA(p<0.0001)and thinner p Ch T(p< 0.005).Center fovea,macular-papillary region and inferior region showed the most significant decrease in choroidal thickness as fundus tessellation exacerbates.?Conclusions?A higher degree of fundus tessellation correlated strongly with the decreases of choroidal and scleral thicknesses in Chinese university students.Choroidal thinning progress more rapidly in the fovea region,macula-papillary region and inferior region as the fundus tessellation exacerbate,which may suggest the tendency of progression towards posterior scleral staphyloma or further myopic maculopathy.Section 2 Characteristics of myopic fundus tessellation and its location in young adults? Purpose ? To explore the characteristics and differences of systematic and ophthalmic factors between normal fundus and tessellated fundus in young adults,and explore the characteristics of different types of fundus tessellation depending on its location.?Methods? Cross-sectional study.A total of 596 adults range from 18 to 49 years old were included in the study and underwent systematic and comprehensive ophthalmic examinations,including swept-source optical coherence tomography(SS-OCT).596 right eyes were included in the analysis and divided into 3 groups by age 18-29 years old(n=280),30-39 years old(n=180)and 40-49 years old(n=136).The topographic variation and factors,average choroidal thickness(Ch T)were measured and analyzed between normal fundus and tessellated fundus in each group.We proposed a novel classification of fundus tessellation based on its location,which are fundus tessellation limited on the nasal region of optic disc(n=69),over nasal region of optic disc without macular region involved(n=205),and macular fundus tessellation(n=216).The topographic variation and Ch T were then analyzed among these three groups and chroid maps were presented to get a intuitionistic perspective of choroid morphology.?Results? Compared with normal fundus,tessellated fundus had lower spherical equivalent(p<0.0001),longer axial length(p< 0.0001)and a significantly thinner choroid thickness(p<0.0001)in all three groups analyzed(group 18-29 years old,30-39 years old and 40-49 years old).Compared among these groups,tessellated fundus had lower spherical equivalent,longer axial length and thinner choroid thickness with the increase of age.Among the three types of fundus tessellation depending on its location,macular fundus tessellation had the lowest spherical equivalent(-5.54±2.53 vs-4.91±2.28 vs-4.20±1.97,p<0.0001),the worst best corrected visual acuity(BCVA)(log MAR 0.04±0.09 vs 0.03±0.07vs 0.02±0.04,p=0.036),the longest axial length(26.24±1.25 vs 25.71±1.03 vs 25.47±0.97,p<0.0001)and the thinnest choroid thickness(170.64±34.75?m vs193.62±39.36?m vs 196.32±36.10?m,p<0.0001).?Conclusion?Myopic fundus tessellation has lower spherical equivalent,longer axial length and a significantly thinner choroid in adults of 18-49 years old.Choroid thickness decreases rapidly in both normal fundus and tessellated fundus at the age of 40-49 years old.Fundus tessellation that involves the macular region is the most severe type compared with other location,and thus to be the vital type in clinical prevention and control.Choroid topographic map has a good prospect in clinical diagnosis and scientific research in myopic maculopathy.