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Association of macular outward scleral height with axial length, macular choroidal thickness and morphologic characteristics of the optic disc in Chinese adults

Eye volume 38, pages 923–929 (2024)Cite this article

Subjects

Abstract

Purpose

To identify the relationship of macular outward scleral height (MOSH) with axial length (AL), macular choroidal thickness (ChT), peripapillary atrophy (PPA), and optic disc tilt in Chinese adults.

Methods

In this cross-sectional study, 1088 right eyes of 1088 participants were enrolled and assigned into high myopia (HM) and non-HM groups. MOSH was measured in the nasal, temporal, superior, and inferior directions using swept-source optical coherence tomography images. The clinical characteristics of MOSH and the association of MOSH with AL, macular ChT, PPA, and tilt ratio were analysed.

Results

The mean age of participants was 37.31 ± 18.93 years (range, 18–86 years), and the mean AL was 25.78 ± 1.79 mm (range, 21.25–33.09 mm). MOSH was the highest in the temporal direction, followed by the superior, nasal, and inferior directions (all p < 0.001). The MOSH of HM eyes was significantly higher than that of non-HM eyes, and it was positively correlated with AL in the nasal, temporal, and superior directions (all p < 0.001). Macular ChT was independently associated with the average MOSH (B = −0.190, p < 0.001). Nasal MOSH was positively associated with the PPA area and the presence of a tilted optic disc (both p < 0.01). Eyes with a higher MOSH in the superior (odds ratio [OR] = 1.008; p < 0.001) and inferior directions (OR = 1.006; p = 0.009) were more likely to have posterior staphyloma.

Conclusion

MOSH is an early indicator of scleral deformation, and it is correlated positively with AL and negatively with ChT. A higher nasal MOSH is associated with a larger PPA area and the presence of a tilted optic disc. Higher MOSH values in the superior and inferior directions were risk factors for posterior staphyloma.

Clinical trial registration

The study was registered at www.clinicaltrials.gov (Reg. No. NCT03446300).

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Fig. 1: Methodology for measurement of macular outward scleral height (MOSH).
Fig. 2: Factors associated with macular outward scleral height (MOSH).

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Data availability

The data analysed during the current study are available from the corresponding author upon reasonable request.

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Funding

This study was supported by the National Natural Science Foundation of China (Project No. 82171100), the Shanghai Municipal Commission of Health (Public Health System 3-Year Plan - Key Subjects) (Project No. GWV-10.1-XK7, GWV-10.2-YQ40), the Clinical Science and Technology Innovation Project of Shanghai Shenkang Hospital (Project No. SHDC12020127), and the National Key Research and Development Program of China (Project No. 2019YFC0840607, 2022YF2502800). The sponsors or funding organizations had no role in the design or conduct of this research.

Author information

Author notes

  1. These authors contributed equally: Menghan Li, Hannan Xu.

  2. These authors jointly supervised this work: Ying Fan, Jiangnan He.

Authors and Affiliations

  1. Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, 200040, China

    Menghan Li, Hannan Xu, Luyao Ye, Siheng Zhou, Jiamin Xie, Jianfeng Zhu, Jiangnan He & Xun Xu

  2. Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200080, China

    Menghan Li, Hannan Xu, Luyao Ye, Siheng Zhou, Jiamin Xie, Chen Liu, Ying Fan & Xun Xu

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  1. Menghan Li
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Contributions

ML and HX interpreted the data and drafted the article; JH and YF analysed the data and substantively revised the article; ML, LY, SZ, JX, and CL conducted the fieldwork for data acquisition; JZ, JH, and YF designed the study. YF and XX made substantial contributions to the conception. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Jiangnan He or Ying Fan.

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The authors declare no competing interests.

Ethics approval and consent to participate

This study involves human participants and was approved by the Ethics Committee of Shanghai General People’s Hospital, Shanghai, China (Approval number: 2015KY156).

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Written informed consent was obtained from each participant

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Li, M., Xu, H., Ye, L. et al. Association of macular outward scleral height with axial length, macular choroidal thickness and morphologic characteristics of the optic disc in Chinese adults. Eye 38, 923–929 (2024). https://doi.org/10.1038/s41433-023-02804-5

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