Myopic macular degeneration causes irreversible structural and functional damage to the fundus, which seriously affects elderly patients' lives. There are few reports on vision-related quality of life in myopic maculopathy patients with low vision, and the factors affecting it are inconclusive.

To assess the vision-related quality of life in myopic macular degeneration patients with low vision and to explore its association with visual function and disease characteristics.

Forty patients with myopic macular degeneration who attended the ophthalmology clinic of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine from September 2022 to January 2023 were included, and visual-related quality of life was assessed by the Low Vision Quality of Life Questionnaire (LVQOL). Best-corrected visual acuity (BCVA), contrast sensitivity (CS) were detected, ATN grading and choroidal thickness based on colored fundus photographs and optical correlation tomography were also recorded. Relationship of vision-related quality of life with ocular parameters and ATN grading was analyzed by Pearson and Spearman correlation, moderating effect of the worse eye on the impact of the better eye's visual function on quality of life was assessed by stratified regression, and generalized linear regression model was used to further confirm the associated factors of vision-related quality of life.

Correlation analysis results showed, LVQOL scores were negatively correlated with BCVA logMAR (r=-0.921, P<0.001), positively correlated with logCS (r=0.943, P<0.001) in better eyes, and positively correlated with logCS in worse eyes (r=0.32, P=0.044). Hierarchical regression analysis showed that the BCVA interaction between worse eyes and better eyes had a statistically significant effect on the total score of LVQOL (β=8.25, P<0.001). LVQOL scores were negatively correlated with atrophic disease (r_s=-0.827, P<0.001) and neovascular disease (r_s=-0.802, P<0.001). Generalized linear regression analysis showed that LVQOL score was positively correlated with sex (β=3.93, P=0.011), logCS (β=18.92, P<0.001) and choroid thickness (β=0.08, P=0.007) in better eyes, and negtively correlated with logMAR (β=-9.93, P=0.016) in better eyes.

Gender, BCVA, CS, and choroidal thickness in the better eye were key factors affecting the quality of life. Future treatment strategies should focus on visual function improvement, disease monitoring and comprehensive management to improve patients' quality of life.