{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T04:04:08Z","timestamp":1779163448314,"version":"3.51.4"},"reference-count":38,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Visual Research Trust","award":["SCOO4516"],"award-info":[{"award-number":["SCOO4516"]}]},{"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"}]},{"name":"Edinburgh Futures Institute","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,7,29]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To conduct the first cross-sectional epidemiological investigation of pathologic myopia (PM) in UK adults with high myopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fundus photographs of 3024 highly myopic eyes (spherical equivalent refraction (SER) \u2264\u22125.00D) from 2000 randomly sampled adults (aged 40\u201370 years) in the UK Biobank were double graded by an ophthalmic reading centre using the Meta-analysis for Pathologic Myopia framework. Adjudication was performed by one of two retinal specialists. Multivariable mixed-effects logistic regression was used to explore potential risk factors and fundus biomarkers\u2014initially adjusting for SER, age and sex, before including these and other variables with p&lt;0.10 in a single model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PM was present in 1138 of 3006 gradable fundus photographs, with 41.7% (95% CI 39.5% to 43.9%) of participants affected in at least one eye graded. Most eyes with PM exhibited diffuse chorioretinal atrophy (97.4%), while the more severe stages\u2014patchy chorioretinal atrophy and macular atrophy\u2014were observed in only 24 and 5 eyes, respectively. 13 eyes had \u2018plus\u2019 lesions or suspected staphyloma. Factors independently associated with increased odds of PM (all p&lt;0.05) included decreasing SER (adjusted OR: 0.22, 95%\u2009CI 0.15 to 0.32), older age (2.20, 1.63 to 2.97), female sex (1.87, 1.12 to 3.12), lower deprivation (0.73, 0.56 to 0.94), white ethnicity (52.3, 17.3 to 158.3), lower retinal arteriovenous ratio (0.47, 0.37 to 0.58), increased retinal vascular complexity (4.60, 3.16 to 6.70) and a relatively horizontal disc orientation (2.98, 1.88 to 4.72). None of the explored modifiable lifestyle or health-related variables were associated with PM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PM prevalence is high among mid-life adults with high myopia in the UK Biobank, although most cases are relatively mild (diffuse chorioretinal atrophy). The only modifiable risk factor identified is myopia severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2024-326889","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T01:55:20Z","timestamp":1756173320000},"page":"204-211","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Epidemiology of pathologic myopia in UK adults with high myopia"],"prefix":"10.1136","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4730-7363","authenticated-orcid":false,"given":"Fabian","family":"Yii","sequence":"first","affiliation":[{"name":"Robert O Curle Ophthalmology Suite, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK"},{"name":"Centre for Clinical Brain Sciences, Institute for Neuroscience and Cardiovascular Research, The University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niall","family":"Strang","sequence":"additional","affiliation":[{"name":"Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel O","family":"Bernabeu","sequence":"additional","affiliation":[{"name":"Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baljean","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Robert O Curle Ophthalmology Suite, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK"},{"name":"Centre for Clinical Brain Sciences, Institute for Neuroscience and Cardiovascular Research, The University of Edinburgh, Edinburgh, UK"},{"name":"Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"MacGillivray","sequence":"additional","affiliation":[{"name":"Robert O Curle Ophthalmology Suite, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK"},{"name":"Centre for Clinical Brain Sciences, Institute for Neuroscience and Cardiovascular Research, The University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian J C","family":"MacCormick","sequence":"additional","affiliation":[{"name":"Robert O Curle Ophthalmology Suite, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK"},{"name":"Centre for Clinical Brain Sciences, Institute for Neuroscience and Cardiovascular Research, The University of Edinburgh, Edinburgh, UK"},{"name":"Institute for Adaptive and Neural Computation, School of Informatics, The University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"2026012202151218000_110.2.204.1","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.61.4.49","article-title":"The Complications of Myopia: A Review and Meta-Analysis","volume":"61","author":"Haarman","year":"2020","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2026012202151218000_110.2.204.2","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.62.5.5","article-title":"IMI Pathologic Myopia","volume":"62","author":"Ohno-Matsui","year":"2021","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2026012202151218000_110.2.204.3","unstructured":"Duke-Elder S , Abrams D . 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