Impact of high myopia on visual disability and its causes in a Spanish cohort.

Purpose: To evaluate visual disability (VD) and associated functional limitations in a Spanish High Myopia (HM) cohort using various disability scales and to identify the main causes of this disability and its impact on daily life.

Methods: This observational study reviewed HM (spherical equivalent (SE)≤-6 D) adults clinical records at IOBA from January 2023 to June 2024. Exclusion criteria included incomplete data and having different pathologies other than pathologic myopia. VD was classified using ICD-10, ICD-11, and Wecker scales. R was used for statistical analysis.

Results: We analysed 600 eyes from 300 patients (73.7 % women, mean age 57.6 ± 15.3 years, mean SE -13.04 ± 6.03 D, mean LogMAR visual acuity 0.52 ± 0.72). According to ICD-11, 7.6 % had mild VD, 12.3 % moderate, 4.7 % severe, and 2.7 % were blind. Wecker scale showed 46.7 % had VD. VD patients were older (p-value= 5.81 × 10^-17) and had more negative SE (p-value=7.96 × 10^-13). No sex differences in VD or pathology frequency were found. Myopic macular atrophy (MMA) (OR=7.816), retinal detachment (OR=3.956), amblyopia (OR=3.455), neovascularization (OR=2.668), SE (OR=1.115), and age (OR=1.040) were statistically significant key factors (p-value<0.05) for greater VD.

Conclusion: This study highlights a significant VD in a Spanish HM cohort being MMA the main cause. Age and SE were found to be relevant factors, as well.This helps to indentify patients more in need of visual rehabilitation.