{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T18:10:45Z","timestamp":1778091045288,"version":"3.51.4"},"reference-count":36,"publisher":"BMJ","funder":[{"DOI":"10.13039\/501100002858","name":"Chinese Postdoctoral Science Foundation","doi-asserted-by":"crossref","award":["2024M763790"],"award-info":[{"award-number":["2024M763790"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Postdoctoral Fellowship Program of the China Postdoctoral Science Foundation","award":["GZC20242104"],"award-info":[{"award-number":["GZC20242104"]}]},{"name":"Science and Technology Projects in Guangzhou","award":["2025A04J7150"],"award-info":[{"award-number":["2025A04J7150"]}]},{"name":"Science and Technology Projects in Guangzhou","award":["SL2024A03J00472"],"award-info":[{"award-number":["SL2024A03J00472"]}]},{"name":"GBRCE for Major Blinding Eye Diseases Prevention and Treatment, the Hainan Province Clinical Medical Center, the National Natural Science Foundation of China","award":["82371086"],"award-info":[{"award-number":["82371086"]}]},{"name":"GBRCE for Major Blinding Eye Diseases Prevention and Treatment, the Hainan Province Clinical Medical Center, the National Natural Science Foundation of China","award":["82401298"],"award-info":[{"award-number":["82401298"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,4,24]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine whether posterior staphyloma (PS) is associated with long-term trajectories of ocular structural changes, myopia-related complications and visual outcomes in high myopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective longitudinal cohort study included 614 highly myopic eyes from the Zhongshan High Myopia Cohort Study, followed for up to 12 years. Eyes were categorised by PS status: baseline PS (n=46), new-onset PS (n=94) or no PS (n=474). The associations between PS and myopic macular degeneration (MMD) progression, myopic traction maculopathy (MTM) and plus lesions incidence, longitudinal changes in ocular parameters and incident moderate-to-severe visual impairment (MSVI) were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PS was independently associated with increased risks of MMD progression (OR 3.39, 95%\u2009CI 1.81 to 6.35, p&lt;0.001), MTM (OR 2.25, 95%\u2009CI 1.06 to 4.77, p=0.034) and incident plus lesions (OR 3.15, 95%\u2009CI 1.16 to 8.57, p=0.024). The highest risks of MTM and plus lesions were observed in eyes with new-onset PS. Eyes with PS demonstrated significantly faster axial elongation (mean annual rate: baseline PS, 0.120 mm (95% CI 0.099 to 0.142); new-onset PS: 0.129\u2009mm (95% CI 0.114 to 0.145); no PS: 0.066\u2009mm (95% CI 0.060 to 0.073), p&lt;0.001) and a fivefold higher risk of MSVI (95% CI 1.36 to 18.45, p=0.016).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PS marks a pivotal structural transition in high myopia, identifying a phase of accelerated axial elongation, increased risk of complications and worse visual outcomes, and may serve as a key marker for risk stratification and an important target for early intervention.<\/jats:p>\n                  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