{ "abstract": "Introduction\n\nThis study assessed the prevalence, associations, and dietary pattern of myopic macular degeneration (MMD), and its effect on vision among older adults in Singapore.Methods\n\nCommunity-dwelling adults aged ≥ 60 years in the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study underwent examinations, including spherical equivalent (SE), axial length (AL), best-corrected visual acuity (BCVA), contrast sensitivity (CS), and fundus photography. Dietary intake was assessed using a validated 110-item interviewer-administered food frequency questionnaire. Dietary patterns were generated by applying exploratory factor analysis. MMD was graded using the meta-analyses of pathologic myopia classification. Associations with MMD were evaluated using multivariable logistic regression, and the impact of MMD on visual outcomes using multivariable linear regression, with SE and AL modelled separately.Results\n\nAmong 1643 phakic participants (mean age 70.6 ± 7.6 years), the age-standardised MMD prevalence was 5.1% (95% confidence interval [CI] 4.0-6.2%), rising from 3.1% (60-65 years) across consecutive 5-year brackets (5.6%, 5.9%, 8.0%, 9.8%) to 13.1% (≥ 85 years). Among high myopes aged ≥ 75 years, MMD prevalence approached 80-100%. Multivariable analyses confirmed that more myopic SE, longer AL, and older age were associated with MMD (all p < 0.001). MMD was associated with worse BCVA and CS, with adjusted differences ranging from 0.05 to 0.10 logMAR and - 0.10 to - 0.15 logCS (all p < 0.05). Dietary patterns were not associated with MMD.Conclusion\n\nMMD poses a substantial public health burden among older Singaporeans, presenting as a near-inevitable complication in older high myopes that drives significant visual impairment in distance acuity and contrast sensitivity. The strong structural and age associations, alongside the absence of a dietary association, highlight the need for primary prevention and structural monitoring in high-risk myopic populations.", "abstract_shown": true, "affiliations": [ "Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Road Discovery Tower, Level 6 The Academia, Singapore, 169856, Singapore.", "Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.", "Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.", "Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore.", "Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Vagelos College of Physicians and Surgeons, New York City, NY, USA.", "Institute for Human Development and Potential, Agency for Science, Technology, and Research, Singapore, Singapore.", "Programme in Health Services Research and Population Health, Duke-NUS Medical School, Singapore, Singapore.", "Department of Ophthalmology and Visual Science, Institute of Science Tokyo, Tokyo, Japan.", "Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.", "Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Road Discovery Tower, Level 6 The Academia, Singapore, 169856, Singapore. preeti.gupta@duke-nus.edu.sg.", "Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore. preeti.gupta@duke-nus.edu.sg." ], "article_type": "research article", "arxiv": null, "author_total": 10, "authors": [ { "affs": [ 0 ], "name": "Kai-Xiong Cheong" }, { "affs": [ 0, 1 ], "name": "Fan Wu" }, { "affs": [ 0, 2, 3, 4 ], "name": "Quan V Hoang" }, { "affs": [ 5 ], "name": "Jun-Shi Lai" }, { "affs": [ 6 ], "name": "Yijia Zhang" }, { "affs": [ 0 ], "name": "Hla Myint Htoon" }, { "affs": [ 7 ], "name": "Kyoko Ohno-Matsui" }, { "affs": [ 0, 6, 8 ], "name": "Ecosse L Lamoureux" }, { "affs": [ 0, 1, 3 ], "name": "Seang-Mei Saw" }, { "affs": [ 9, 10 ], "name": "Preeti Gupta" } ], "bibtex": "https://research.draconitic.com/paper/5a1k9177tnj8e.bib", "cited_by": 0, "doi": "10.1007/s40123-026-01514-x", "fulltext_url": "https://europepmc.org/articles/PMC13694633", "id": "5a1k9177tnj8e", "issns": [ "2193-8245", "2193-6528" ], "landing_url": "https://europepmc.org/article/MED/42832167", "language": "eng", "licence": "CC-BY-NC", "licence_label": "CC BY-NC", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "lcc", "RE1-994" ], [ "openalex", "2713|Ophthalmology and Visual Impairment Studies" ] ], "openalex": "W7220463890", "pdf_url": "https://europepmc.org/articles/PMC13694633?pdf=render", "pmcid": "PMC13694633", "pmid": "42832167", "published": "2026-10-05", "publisher": "Adis, Springer Healthcare", "ris": "https://research.draconitic.com/paper/5a1k9177tnj8e.ris", "sources": [ { "first_seen": "2026-10-30T12:18:10Z", "native_id": "MED:42832167", "source": "europepmc", "url": "https://europepmc.org/article/MED/42832167" }, { "first_seen": "2026-10-30T13:45:45Z", "native_id": "5dfccdf497f74ac58d68f67b6658c6b7", "source": "doaj", "url": "https://doi.org/10.1007/s40123-026-01514-x" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2713|Ophthalmology and Visual Impairment Studies", "subfield": "epidemiology-public-health" } ], "title": "Prevalence, Associations, and Visual Impact of Myopic Macular Degeneration in a Multi-ethnic Older Population in Singapore: The PIONEER Study.", "title_text": "Prevalence, Associations, and Visual Impact of Myopic Macular Degeneration in a Multi-ethnic Older Population in Singapore: The PIONEER Study.", "type": "peer-reviewed", "updated_at": "2026-10-30T13:45:45Z", "url": "https://research.draconitic.com/paper/5a1k9177tnj8e", "venue": "Ophthalmology and therapy", "versions": [] }