Factors associated with axial length elongation in high myopia in adults.

Aim: To investigate the association of axial length (AL) and ocular factors on AL elongation.

Methods: A retrospective chart review of patients who underwent two or more AL examinations for more than two years. Totally 4 groups were divided according to initial AL (<24 mm, 24-26 mm, 26-28 mm, ≥28 mm). Initial fundus photograph was used to find risk factors associated AL elongation.

Results: The mean age of the patients was 47.21±7.79y. AL remained almost unchanged in the groups with AL<24 mm and 24≤AL<26 mm. On the contrary, AL increased by 0.011 mm/y in the group with 26≤AL<28 mm and 0.035 mm/y in the group with AL≥28 mm (<0.001). In high myopia, AL elongation increased in eye with longer AL (=0.003, =0.024), female gender (=0.014, =0.019), eye with larger peripapillary chorioretinal atrophic area (=0.002, =0.019), and smaller vascular arcade angle (=-0.004, =0.006). The risk of elongation 0.03 mm/y in high myopia was increased in female gender (=0.040), and gradually increased in eye with large peripapillary chorioretinal atrophy area (<0.01).

Conclusion: AL elongate significantly in the eye with longer AL, female gender, and the eye with larger atrophic area and smaller arcade angle on fundus photography.