{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T01:25:22Z","timestamp":1771464322206,"version":"3.50.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n            <jats:title>Purpose:<\/jats:title>\n            <jats:p>To assess the reliability of the atrophy-traction-neovascularization (ATN) classification in patients with pathologic myopia (PM) and its correlation with best-corrected visual acuity (BCVA).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Cross-sectional study. Hundred highly myopic eyes with a spherical equivalent of &gt;\u22126.0 diopters or axial length of &gt;26 mm and a total ATN score of \u22653 underwent a complete ophthalmological examination, including fundus photography and swept-source optical coherence tomography. Five observers graded each eye using the ATN system. Mean A, T, and N scores were calculated and correlated with age, BCVA (in logarithm of the minimum angle of resolution), and axial length. Patients were considered to present severe PM if either A or T components were \u22653 and\/or N was \u22652.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Hundred eyes (53 left) from 91 patients (78 women) were classified. Mean age, BCVA, and axial length values were, respectively, 65.1 \u00b1 11.7 years (range, 36\u201397 years), \u22120.63 \u00b1 0.62 (\u22123.00 to 0.00), and 29.26 \u00b1 2.7 mm (26.01\u201337.66 mm). Mean ATN grades for each component were as follows: A = 2.51 \u00b1 0.78 (0.6\u20134.0), T = 0.88 \u00b1 1.14 (0.0\u20135.0), and N = 1.31 \u00b1 1.40 (0.0\u20133.0). Weighted interobserver agreement was 98.1%, 98.7%, and 94.6%, for A, T and N, respectively. In eyes with severe PM, BCVA was significantly lower and axial length was significantly longer.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>The excellent interobserver rate in this study demonstrates that the updated ATN grading system is an accurate and reliable tool to classify patients with PM. These findings show that BCVA is more compromised in eyes with severe PM, particularly those graded \u2265A3 and\/or T3.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/iae.0000000000003129","type":"journal-article","created":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T16:27:27Z","timestamp":1613924847000},"page":"1867-1873","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["CORRELATION BETWEEN ATROPHY-TRACTION-NEOVASCULARIZATION GRADE FOR MYOPIC MACULOPATHY AND CLINICAL SEVERITY"],"prefix":"10.1097","volume":"41","author":[{"given":"Jorge","family":"Ruiz-Medrano","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain;"}]},{"given":"Ignacio","family":"Flores-Moreno","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain;"}]},{"given":"Kyoko","family":"Ohno-Matsui","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Science at Tokyo Medical and Dental University, Tokio, Japan;"}]},{"given":"Chui Ming Gemmy","family":"Cheung","sequence":"additional","affiliation":[{"name":"Singapore National Eye Centre, Singapore Eye Research Institute, Singapore;"}]},{"given":"Rufino","family":"Silva","sequence":"additional","affiliation":[{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal;"},{"name":"Ophthalmology Department, Centro Hospitalar e Universit\u00e1rio de Coimbra (CHUC), Coimbra, Portugal;"},{"name":"Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal;"},{"name":"Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal;"}]},{"given":"Jos\u00e9 M.","family":"Ruiz-Moreno","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain;"},{"name":"Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain;"},{"name":"Vissum Corporation, Spain; and"},{"name":"Red Tem\u00e1tica de Investigaci\u00f3n Cooperativa en Salud, \u201cPrevenci\u00f3n, detecci\u00f3n precoz, y tratamiento de la patolog\u00eda ocular prevalente, degenerativa y cr\u00f3nica\u201d (RD16\/0008\/0021), Spanish Ministry of Health, Instituto de Salud Carlos III, Madrid, Spain."}]}],"member":"276","reference":[{"key":"R1-20250609","doi-asserted-by":"crossref","first-page":"247","DOI":"10.3109\/09286586.2014.928824","article-title":"Differences in prevalence of refractive errors in young asian males in Singapore between 1996\u20131997 and 2009\u20132010","volume":"21","author":"Koh","year":"2014","journal-title":"Ophthalmic Epidemiol"},{"key":"R2-20250609","doi-asserted-by":"crossref","first-page":"5466","DOI":"10.1167\/iovs.13-12478","article-title":"Prevalence and risk factors for myopia in a rural Korean population","volume":"54","author":"Lee","year":"2013","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"R3-20250609","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1016\/S0140-6736(12)60272-4","article-title":"Myopia","volume":"379","author":"Morgan","year":"2012","journal-title":"The Lancet"},{"key":"R4-20250609","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/j.ophtha.2006.04.022","article-title":"Prevalence and causes of low vision and blindness in a Japanese adult population. 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