Prediction of axial elongation in adults with high myopia: the Wenzhou High Myopia Cohort Study - PubMed
4 hours ago
- #high myopia
- #choroidal thickness
- #axial elongation
- This study aimed to identify optimal predictors for axial elongation in adults with high myopia.
- A prospective cohort of 1025 eyes from 532 adults with high myopia was analyzed over two years, defining rapid axial elongation as ≥0.10 mm.
- The mean annual axial elongation rate was 0.020 ± 0.051 mm/year, with 24.78% of eyes experiencing rapid elongation.
- A full model with six predictors (age, sex, axial length, best-corrected visual acuity, choroidal thickness (ChT), and vascularity index) achieved an AUC of 0.811.
- ChT (AUC=0.728) and age (AUC=0.666) were the strongest individual predictors; removing either significantly reduced model performance.
- Simplified models combining age and ChT, with or without sex, performed comparably to the full model with only modest reductions.
- The predictive cutoff for ChT decreased with age, from 187 µm at age 20 to 29 µm at age 60.
- Results were consistent across sensitivity analyses using different elongation definitions (0.05 mm and 0.15 mm).
- Non-linear analysis showed thinner choroids were associated with faster axial elongation only below an inflection point.
- ChT and age are identified as the optimal predictors, supporting personalized, choroid-centered management strategies for high myopia.