PURPOSE: We investigated relationships between two dietary composite scores and myopic macular degeneration (MMD) in a high myopia adult cohort, as there is a knowledge gap regarding the role of diet in MMD. METHODS: This is a cross-sectional analysis of a population-based prospective cohort, the Aier-Singapore Eye Research Institute (SERI) high myopia cohort study of Chinese adults, in Changsha, central China. Systemic and ocular (including cycloplegic spherical equivalent [SE] and axial length [AL]) assessments were carried out. A self-administered food frequency questionnaire was used to assess the dietary intake. Dietary intake was categorised into 13 food groups (refined grains, whole grains, meat, fish, processed/unhealthy meat, plant-based protein, fruits, vegetables, fast food and savoury snacks, dairy products, desserts and sweet snacks, sugar-sweetened beverages, and alcohol). Using exploratory factor analysis, two dietary patterns (Dietary Pattern 1 [less healthy] and 2 [healthier]) were identified. Multivariable logistic regression analyses with Bonferroni corrections were performed to assess associations between diet and MMD. RESULTS: Of 445 participants, 71 (16.0%) had MMD. The participants had an overall mean age of 42.3 ± 7.3 years, SE of -9.5 ± 4.3 dioptres (D) and AL of 27.3 ± 11.86 mm. In the multivariable analyses, none of the 13 food groups (p >
0.004 for all) or 2 dietary patterns (p >
0.05 for both) were associated with MMD, after adjusting for age, sex, education, SE and AL. CONCLUSION: We did not find associations between diet and MMD in a cohort of highly myopic adults. There is currently no dietary advice to prevent MMD. Larger and prospective studies conducted over multiple time points are required.