ORIGINAL RESEARCH article
Front. Med.
Sec. Ophthalmology
This article is part of the Research TopicDiagnostic Burdens in High MyopiaView all 6 articles
Clinical Spectrum and Prevalence Associations of Chorioretinal Damage in High Myopia: A Retrospective Cross-Sectional Analysis
Provisionally accepted
- 1Lanzhou Aier Eye Hospital, Lanzhou，Gansu，730000，China, Gansu, China
- 2Gansu Aier Optometry Hospital, Lanzhou，Gansu，730000，China, Gansu, China
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Background High myopia is a growing public-health challenge linked to irreversible chorioretinal damage and vision loss. Understanding its clinical spectrum and identifying predictors of early structural injury are essential for risk-stratified surveillance. Despite progress in imaging and diagnostic classification, population-level evidence describing lesion patterns and predictive factors in high-burden clinical settings remains limited. Methods The cross-sectional retrospective study evaluated 1,420 patients (2,610 eyes) with high myopia examined between 2015 and 2024 at Lanzhou Aier Eye Hospital. Eligibility was based on refractive or biometric criteria and availability of multimodal imaging. Chorioretinal changes were graded using the ATN classification. Descriptive statistics summarized demographics and imaging findings. Prevalence of each lesion type was estimated with confidence intervals. Univariable comparisons and multivariable logistic regression with clustered variance identified independent predictors. Model calibration and discrimination were assessed, with prespecified sensitivity analyses based on axial length, age strata, and exclusion of treated choroidal neovascularization. Missing data were imputed using chained equations. Results Chorioretinal damage was documented in 40.0% of eyes. Diffuse atrophy (16.1%), foveoschisis (11.9%), and patchy atrophy (8.2%) were the most frequent lesions. Older age, greater axial length, more negative spherical equivalent, and thinner choroid were independently associated with the presence of pathology. The final model demonstrated stable calibration and high discrimination across sensitivity analyses. Projected estimates indicated considerable population-level burden, particularly in individuals with axial length ≥32 mm. Conclusion High-myopia eyes show substantial structural vulnerability, and key biometric parameters can support targeted early surveillance. The findings contribute new epidemiological evidence from a large clinical cohort and highlight practical risk-stratification markers suitable for public-health planning in regions facing rapid growth in myopia prevalence.
Keywords: chorioretinal damage, clinical outcomes, Epidomology analysis, Myopia, predictors
Received: 02 Dec 2025; Accepted: 26 Jan 2026.
Copyright: © 2026 Li, Wang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xueyi Chen
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