Study Finds Myopic Maculopathy in Nearly One-Third of Pediatric High Myopes

Tessellated fundus, also called tigroid fundus, is caused by thinning of the choroid and retinal pigment epithelium, leading to the visibility of choroidal vessels. It was the most frequently seen complication of high myopia in this cohort. Photo: Hayashi K, Ohno-Matsui K, Shimada N, et al. Ophthalmology. 2010;117:1595-161. Click image to enlarge. Although myopic maculopathy (MM) is a well-known complication of high myopia, clinicians likely assume it doesn’t manifest until well into adulthood. A new study conducted in China challenges that notion.Patients consisted of 155 subjects with refractive error of -6D or greater between seven and 17 years of age. The average age of the cohort was 13.6 years and 56.1% of subjects were female; additionally, the researchers stated in a paper for American Journal of Ophthalmology, “the cohort consisted exclusively of Chinese participants,” a limitation that may have “impair[ed] result generalizability.” No other health problems were reported.After the completion of the baseline findings, patients were followed up with for eight more years, with follow-ups occurring routinely every two years. At each visit, clinicians performed standardized exams where they measured patients’ axial length (AL), intraocular pressure and BCVA,  and took fundus photographs “of every fully dilated eye.”Over the study’s eight-year follow-up period, 31.3% of eyes showed MM progression and “a total of 97 participants demonstrated 112 lesion changes, with the most common being the new appearance of tessellated fundus (44.6%).” The researchers noted in their paper that a combination of baseline axial length and a two-year AL change rate were superior at predicting maculopathy progression over a prolonged time period “compared to baseline AL alone.” In addition, they found that younger patients who initially presented with longer baseline AL, those who had experienced faster early elongation and subjects with more severe myopia were all at higher risk of MM progression.The study highlighted how short-term axial elongation acts as a signal for later problems, particularly MM, of greater severity, as well as emphasizing the necessity of monitoring AL changes in young patients to prevent such problems later in life.Click here for the journal source. Jiang F, Wang L, Ding X, et al. Short-term axial length changes predict progression of myopic maculopathy in pediatric high myopia. Am J Ophthalmol. March 16, 2026. [Epub ahead of print].  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.