Factors associated with macular thickness in the COMET myopic cohort

Optom Vis Sci. 2012 May;89(5):620-31. doi: 10.1097/OPX.0b013e318251293a.

Abstract

Purpose: To determine whether macular thickness is associated with ethnicity, gender, axial length (AL), and severity of myopia in a cohort of young adults from the Correction of Myopia Evaluation Trial (COMET).

Methods: Eleven years after their baseline visit, 387/469 (83%) subjects returned for their annual visit. In addition to the protocol-specific measures of spherical equivalent refractive error (SER) and AL, high-resolution macular imaging also was performed with optical coherence tomography (RTVue). From these scans, full-thickness values for the central (1 mm), parafoveal (1 to 3 mm), and perifoveal (3 to 5 mm) annular regions were calculated. Gender, ethnicity, AL, and SER were examined for associations with macular thickness using univariate and multivariable linear regression analyses.

Results: In the 377 subjects with usable data (mean age = 21.0 ± 1.3 years), the mean SER ± SD was -5.0 ± 1.9 D and mean AL was 25.4 ± 0.9 mm. Mean foveal thickness was 252.0 ± 20.1 μm in the center, 315.6 ± 14.0 μm in the parafovea, and 284.4 ± 12.9 μm in the perifovea. In the best-fit multivariable model that adjusted for gender, ethnicity, and AL, females had significantly thinner maculas than males for all three regions (p < 0.0001), with the largest difference in the center (12.8 μm, 95% confidence interval: 9.2 to 16.4). The effect of ethnicity was strongest in the central fovea, with African-Americans, Asians, Hispanics, and mixed ethnic groups having thinner maculas than whites (all p values < 0.005). Increased AL was significantly associated with slightly thicker central foveas (p = 0.001) and thinner parafoveal (p = 0.02) and perifoveal (p < 0.0001) regions.

Conclusions: In this ethnically diverse cohort of moderate and high myopes, females and African-Americans were found to have the thinnest central foveas. Whether such thinning in the macula as a young adult is a risk factor for future disease remains to be determined.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Age Factors
  • Diagnosis, Differential
  • Disease Progression
  • Ethnicity*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Macula Lutea / pathology*
  • Male
  • Myopia / diagnosis*
  • Myopia / ethnology
  • Prognosis
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Tomography, Optical Coherence / methods*
  • United States / epidemiology
  • Young Adult