![]() ![]() Herein, we again demonstrate the disparity in populations affected by APPM and MPM based on age and gender. The study was limited by its reliance on ICD coding and lack of refraction data more myopic refractive error is linked to CPM and MPM as compared to APPM. This study is strengthened by its large number of participants. ![]() Differences between males and females are likely driven by a known increased risk of RRD in males. These results align with previous findings of unique subgroups of high myopia with differences in age and gender: (1) MPM patients are more likely to be older females and (2) APPM patients to be younger males, and (3) younger patients are more likely to be diagnosed with APPM while (4) older patients are more likely to have MPM. Males had an 18.0% greater risk (95% CI, 15.8 to 20.3%) of APPM as compared to females. Females had a 20.9% greater risk (95% CI, 17.6 to 24.4%) of MPM as compared to males. The study population included 54,875 patients (106,243 eyes, Table 1). Analyses were performed based on individual eye classification. The influence of gender and age on classification were examined using crude bivariate analyses (chi-squared, ANOVA, relative risk). ![]() Subgroups were defined as APPM (lattice degeneration, rhegmatogenous retinal detachment, retinal tear, retinoschisis), MPM (myopic maculopathy, macular hole, staphyloma, angioid streaks, retinal neovascularization, cystoid macular degeneration, exudative retinopathy, retinal pigmented epithelium detachment, vitreomacular adhesion, epiretinal membrane), combined pathologic myopia (CPM diagnosis from each of the aforementioned two categories), and isolated high myopia (IHM). Predetermined ICD diagnoses were then used to classify patients with high myopia into previously described subgroups, with slight modifications for clarity (anterior pathologic myopia, APM, renamed anterior peripheral pathologic myopia, APPM posterior pathologic myopia, PPM, renamed macular pathologic myopia, MPM). Study participants were identified using ICD-9/ICD-10 codes 360.21/H442. Using aggregated de-identified data from the Vestrum Health Database (Naperville, IL, USA), we performed a retrospective study of patients with high myopia enrolled from Januto December 31, 2019. We tested these findings in a larger dataset. However, we demonstrated in a single center that high myopia can be classified into anterior and posterior high myopia, with different risk profiles based on gender and age, suggesting different etiologies for these presentations. Most literature on high myopia focuses on posterior findings such as myopic maculopathy and posterior staphyloma. The etiology of high myopia is multifactorial with both environment and genetics playing a role in axial elongation. Uncorrected refractive error is the second most common cause of blindness and moderate and severe vision impairment in the world. ![]()
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