{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:55:39Z","timestamp":1791352539764,"version":"4.3.1"},"reference-count":85,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/N013166\/1"],"award-info":[{"award-number":["MR\/N013166\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To synthesise evidence across studies on factors associated with pathologic myopia (PM) onset and progression based on the META\u2010analysis for Pathologic Myopia (META\u2010PM) classification framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Findings from six longitudinal studies (5\u201318\u2009years) were narratively synthesised and meta\u2010analysed, using odds ratio (OR) as the common measure of association. All studies adjusted for baseline myopia, age and sex at a minimum. The quality of evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five out of six studies were conducted in Asia. There was inconclusive evidence of an independent effect (or lack thereof) of ethnicity and sex on PM onset\/progression. The odds of PM onset increased with greater axial length (pooled OR: 2.03; 95% CI: 1.71\u20132.40;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), older age (pooled OR: 1.07; 1.05\u20131.09;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and more negative spherical equivalent refraction, SER (OR: 0.77; 0.68\u20130.87;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), all of which were supported by an acceptable level of evidence. Fundus tessellation was found to independently increase the odds of PM onset in a population\u2010based study (OR: 3.02; 2.58\u20133.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), although this was only supported by weak evidence. There was acceptable evidence that greater axial length (pooled OR: 1.23; 1.09\u20131.39;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), more negative SER (pooled OR: 0.87; 0.83\u20130.92;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and higher education level (pooled OR: 3.17; 1.36\u20137.35;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) increased the odds of PM progression. Other baseline factors found to be associated with PM progression but currently supported by weak evidence included age (pooled OR: 1.01), severity of myopic maculopathy (OR: 3.61), intraocular pressure (OR: 1.62) and hypertension (OR: 0.21).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most PM risk\/prognostic factors are not supported by an adequate evidence base at present (an indication that PM remains understudied). Current factors for which an acceptable level of evidence exists (limited in number) are unmodifiable in adults and lack personalised information. More longitudinal studies focusing on uncovering modifiable factors and imaging biomarkers are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.13312","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T11:56:43Z","timestamp":1712059003000},"page":"963-976","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Factors associated with pathologic myopia onset and progression: A systematic review and meta\u2010analysis"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4730-7363","authenticated-orcid":false,"given":"Fabian","family":"Yii","sequence":"first","affiliation":[{"name":"Centre for Clinical Brain Sciences The University of Edinburgh  Edinburgh UK"},{"name":"Curle Ophthalmology Laboratory, Institute for Regeneration and Repair The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Nguyen","sequence":"additional","affiliation":[{"name":"MRC Human Genetics Unit, Institute of Genetics and Cancer The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall","family":"Strang","sequence":"additional","affiliation":[{"name":"Department of Vision Sciences Glasgow Caledonian University  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel O.","family":"Bernabeu","sequence":"additional","affiliation":[{"name":"Centre for Medical Informatics Usher Institute, The University of Edinburgh  Edinburgh UK"},{"name":"The Bayes Centre The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Tatham","sequence":"additional","affiliation":[{"name":"Centre for Clinical Brain Sciences The University of Edinburgh  Edinburgh UK"},{"name":"Princess Alexandra Eye Pavilion NHS Lothian  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"MacGillivray","sequence":"additional","affiliation":[{"name":"Centre for Clinical Brain Sciences The University of Edinburgh  Edinburgh UK"},{"name":"Curle Ophthalmology Laboratory, Institute for Regeneration and Repair The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baljean","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Centre for Clinical Brain Sciences The University of Edinburgh  Edinburgh UK"},{"name":"Curle Ophthalmology Laboratory, Institute for Regeneration and Repair The University of Edinburgh  Edinburgh UK"},{"name":"Princess Alexandra Eye Pavilion NHS Lothian  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,2]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"312","article-title":"Axial length measurements and fundus changes of the myopic eye. 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