Purpose: To assess the association between axial length (AL) and the prevalence of myopic maculopathy in a general Japanese population. Design: Population-based cross-sectional study. Participants: A total of 2790 Hisayama residents 40 years of age or older who consented to participate and had available data of AL and fundus photographs for the right eyes were enrolled in this study. Methods: Myopic maculopathy was defined as the presence of diffuse chorioretinal atrophy, patchy chorioretinal atrophy, or macular degeneration. The optimal cutoff values of axial length for identifying myopic maculopathy were estimated from the receiver operating characteristic curve. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a logistic regression analysis. Main Outcome Measures: Odds ratios of AL for prevalent myopic maculopathy and the optimal cutoff values of AL for detecting myopic maculopathy. Results: Longer AL was associated significantly with prevalence of myopic maculopathy in both genders. The optimal cutoff values of AL for identifying myopic maculopathy were 25.9 mm in men and 25.3 mm in women. Participants with ALs of these values or longer showed a significantly higher OR for myopic maculopathy than those with AL of less than these values (men: OR, 21.23; 95% CI, 8.74–51.57; women: OR, 38.49; 95% CI, 18.03–86.49). Conclusions: The present study found that there was a positive association between AL and the likelihood of myopic maculopathy, and the cutoff levels of AL for identifying myopic maculopathy were 25.9 mm in men and 25.3 mm in women. Our findings suggest that patients with AL close to or longer than these values should undergo intensive treatment and detailed ophthalmic follow-up.
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