PURPOSE To analyze the choroidal thickness (CT) of each type of myopic maculopathy, and to establish an OCT-based classification of myopic maculopathy. DESIGN Retrospective, hospital-based, cross-sectional study. PARTICIPANTS Highly myopic (HM) eyes that were examined by swept-source OCT. METHODS The CT was measured at the subfovea and at 3 mm nasal, temporal, superior, and inferior to the fovea. Myopic maculopathy was classified as tessellation, diffuse atrophy, patchy atrophy, and macular atrophy (MA) based on the fundus photographs. Diffuse atrophy was subdivided into peripapillary diffuse choroidal atrophy (PDCA) or macular diffuse choroidal atrophy (MDCA). MAIN OUTCOME MEASURES The CT of each type of myopic maculopathy and cut-off value for diagnosis of diffuse atrophy. RESULTS We studied 1487 eyes of 884 patients (mean age: 58 years; mean axial length [AxL]: 29.9 mm). Subfoveal CT decreased with an increase in the severity of the myopic maculopathy. The mean subfoveal CT in HM eyes with normal fundus was 274.5 μm, with tessellation was 129.1 μm, with PDCA was 84.6 μm, with MDCA was 50.2 μm, with patchy atrophy was 48.6 μm, with choroidal neovascularization-related MA was 27.3 μm, and with patchy atrophy-related MA was 3.5 μm. Using receiver operating characteristic curves, the optimal CT to predict the presence of PDCA was 56.5 μm nasally, and the CT to predict the presence of MDCA was 62 μm subfoveally. The subfoveal CT was not significantly different in eyes with MDCA and patchy atrophy. A decrease of the subfoveal CT was associated with an older age (P < 0.001), longer AxL (P < 0.001), presence of myopic maculopathy (P < 0.001), and presence of CNV (P = 0.002). A decrease of best-corrected visual acuity was not significantly associated with the subfoveal CT. CONCLUSIONS Progressive and continuous choroidal thinning plays a key role in the progression from no maculopathy to tessellation and to diffuse atrophy. The cut-off value of CT can be used for diagnosing PDCA and MDCA. For progression from MDCA to patchy atrophy, factors other than further choroidal thinning such as Bruch membrane defect may be involved. The subfoveal CT was not a predictor of visual acuity in HM eyes without CNV.

中文翻译：

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基于OCT的近视黄斑病变不同阶段的诊断标准。

目的分析每种类型的近视性黄斑病变的脉络膜厚度（CT），并建立基于OCT的近视性黄斑病变的分类。设计回顾性，基于医院的横断面研究。参与者通过扫频OCT检查的高度近视（HM）眼睛。方法CT测量在中央凹下和中央凹3mm处，颞侧，上，下3毫米处。根据眼底照片，近视性黄斑病变可分为棋盘状，弥漫性萎缩，斑块性萎缩和黄斑萎缩（MA）。弥漫性萎缩可分为乳头状弥漫性脉络膜萎缩（PDCA）或黄斑性弥漫性脉络膜萎缩（MDCA）。主要观察指标每种类型的近视黄斑病变的CT和诊断弥漫性萎缩的临界值。结果我们研究了884例患者的1487眼（平均年龄：58岁；平均58岁）。平均轴向长度[AxL]：29.9毫米）。随着近视性黄斑病变的严重程度增加，中央凹下CT降低。眼底正常的HM眼的平均中央凹下CT为274.5μm，棋盘形为129.1μm，PDCA为84.6μm，MDCA为50.2μm，斑块性萎缩为48.6μm，与脉络膜新生血管相关的MA为27.3μm，以及斑块状萎缩相关的MA为3.5μm。使用接收器的工作特性曲线，预测鼻腔下方PDCA存在的最佳CT为56.5μm，预测鼻腔MDCA存在的CT为62μm。患有MDCA和斑块状萎缩的眼睛的中央凹下CT差异无统计学意义。中央凹下CT的降低与年龄较大（P <0.001），AxL较长（P <0.001），近视性黄斑病变（P <0.001）和CNV（P = 0.002）有关。最佳中央矫正视力的降低与中央凹下CT并没有显着相关。结论进行性和连续性脉络膜变薄在从无黄斑病到棋盘形和弥漫性萎缩的过程中起着关键作用。CT的截止值可用于诊断PDCA和MDCA。对于从MDCA到斑块状萎缩的进展，可能会涉及除脉络膜变薄以外的其他因素，例如Br​​uch膜缺损。没有CNV的HM眼的中央凹下CT不能预测视力。对于从MDCA到斑块状萎缩的进展，可能会涉及除脉络膜变薄以外的其他因素，例如Br​​uch膜缺损。没有CNV的HM眼的中央凹下CT不能预测视力。对于从MDCA到斑块状萎缩的进展，可能会涉及除脉络膜变薄以外的其他因素，例如Br​​uch膜缺损。没有CNV的HM眼的中央凹下CT不能预测视力。