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.

近视性黄斑病变造成的眼底结构损伤及功能损害无法恢复，严重影响老年患者生活。目前关于近视性黄斑病变低视力患者生活质量的评估鲜少报道，其影响因素也尚无定论。

评估近视性黄斑病变低视力患者的视觉相关生活质量现状，并探究其与视觉功能、病变特征等因素之间的关联。

纳入2022年9月—2023年1月就诊于上海交通大学医学院附属第一人民医院眼科门诊的40例近视性黄斑病变的低视力患者，采用低视力生活质量量表（LVQOL）评估患者视觉相关生活质量，测量患者最佳矫正视力（BCVA）、对比敏感度（CS），并基于彩色眼底照相和光学相干断层扫描记录近视性黄斑病变的分类（ATN分级）和脉络膜厚度。通过Pearson相关分析和Spearman秩相关分析方法探讨视觉相关生活质量与眼部参数、ATN分级的相关性，通过分层回归分析评估较差眼对较好眼视觉功能的调节作用，并采用广义线性回归模型进一步确认视觉相关生活质量的影响因素。

相关性分析结果显示，LVQOL评分与较好眼的BCVA最小分辨视角的对数（logMAR）呈负相关（r=-0.921，P<0.001），与logCS呈正相关（r=0.943，P<0.001），与较差眼logCS呈正相关（r=0.32，P=0.044）；分层回归分析显示，较差眼与较好眼BCVA之间的交互作用对LVQOL总分影响有统计学意义（β=8.25，P<0.001）；LVQOL评分与萎缩性病变（r_s=-0.827，P<0.001）、新生血管性病变（r_s=-0.802，P<0.001）分级呈负相关；广义线性回归分析结果显示，LVQOL评分与性别（β=3.93，P=0.011）及较好眼logCS（β=18.92，P<0.001）和脉络膜厚度（β=0.08，P=0.007）呈正相关，与较好眼logMAR（β=-9.93，P=0.016）呈负相关。

BCVA、CS、ATN分级严重程度及较好眼脉络膜厚度是影响视觉相关生活质量的关键因素。未来治疗策略应注重视觉功能改善、结构指标监测和病程综合管理，以改善患者的生活质量。