Prevalence, Risk Factors, and Impact of Myopic Macular Degeneration on Visual Impairment and Functioning Among Adults in Singapore

  • The purpose of this study is to determine the prevalence, risk factors, and impact of myopic(MMD) on visual impairment and functioning among adults in Singapore.

  • A comprehensive eye examination, including subjective refraction, axial length, and visual acuity (VA) measurements, was performed in adults aged ≥40 years in the Singapore Epidemiology of Eye Diseases (SEED) study using fundus photographs.

  • A total of 8716 phakic subjects were included in this analysis. The mean age (± SD) was 57.2 ± 9.5 years (33.5% Malays, 33.2% Indians, and 33.3% Chinese).

  • The prevalence of myopia (spherical equivalent [SE] ≤ −0.5 diopters [D]) and high myopia (SE ≤ −5.0 D) was 35.7% and 6.0%, respectively. The age-standardized prevalence of MMD was 3.8% (95% confidence interval [CI], 3.4–4.3%). The prevalence of MMD was 7.7% among low to moderate myopes, and 28.7% among high myopes.

  • The prevalence of MMD increased nonlinearly with SE and age. MMD was associated with older age, more myopic SE, and lower education. Subjects with Meta-PM categories 3 or 4 in the better-seeing eye had worse best-corrected VA (β, 0.19; 95%CI, 0.16–0.23) and poorer VSF (β, −9.7; 95%CI, −17.6 to −1.8) than those without MMD after multivariate adjustments.

  • Approximately 1 in 26 phakic adults in Singapore has MMD. Older age and myopic SE are major risk factors of MMD. Severe MMD has a substantial impact on visual impairment and functioning.

Publication date

September 19, 2018


Investigative Ophthalmology & Visual Science, Arvo Journal

Sponsor Institution

Singapore Eye Research Institute


Yee-Ling Wong; Charumathi Sabanayagam; Yang Ding; Chee-Wai Wong; Anna Chwee-Hong Yeo; Yin-Bun Cheung; Gemmy Cheung; Audrey Chia; Kyoko Ohno-Matsui; Tien-Yin Wong; Jie Jin Wang; Ching-Yu Cheng; Quan V. Hoang; Ecosse Lamoureux; Seang-Mei Saw
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