Understanding Pathologic Myopia

Ohno‐Matsui, Kyoko; Jonas, Jost B.

doi:10.1007/978-981-13-8491-2_9

Cited by 13 publications

(14 citation statements)

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“…Myopic maculopathy was graded as suggested by the Meta-analysis for Pathologic Myopia Study Group. 4 Recent publications described the study design in detail. [9][10][11]…”

Section: Methodsmentioning

confidence: 99%

“…1 Because myopia, mainly high myopia, can lead to marked loss in vision due to the sequelae of myopic maculopathy and high myopia-associated optic neuropathy, myopic maculopathy has become one of the most common causes of irreversible vision loss. [2][3][4][5][6][7] Despite the importance of myopic maculopathy in public health, to our knowledge, no information has been available thus far about the prevalence of myopic maculopathy in Russia, Eastern Europe, and Central Asia, although Russia is by area the world´s largest and by population one of the most populous countries. 8 It has also remained unclear which systemic factors and major diseases are associated with a higher prevalence of myopic maculopathy.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Myopic Maculopathy Among Adults in a Russian Population

et al. 2020

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IMPORTANCE Although myopic maculopathy has become a major cause of vision impairment worldwide, few data from Russia and Central Asia on the prevalence of myopic maculopathy have been available. OBJECTIVE To assess the prevalence of myopic maculopathy and its associations with ocular and systemic parameters in a population in Russia. DESIGN, SETTING, AND PARTICIPANTS The Ural Eye and Medical Study, a population-based casecontrol study, was conducted in rural and urban areas in Bashkortostan, Russia, from October 26, 2015, to July 4, 2017. Data analysis was performed from September 13 to September 15, 2019. The Ural Eye and Medical Study included 5899 of 7328 eligible individuals (80.5%) aged 40 years or older. EXPOSURES A detailed ocular and systemic examination included fundus photography and optic coherence tomography for the assessment of myopic maculopathy. MAIN OUTCOMES AND MEASURES Prevalence of myopic maculopathy. RESULTS The present investigation included 5794 of the 5899 eligible individuals (98.2%; 3277 [56.6%] women; mean [SD] age, 58.9 [10.7] years) with available information about myopic maculopathy. Mean (SD) axial length was 23.3 (1.1) mm (range, 19.78-32.87 mm). Prevalence of any myopic maculopathy was 1.3% (95% CI, 1.0%-1.6%); myopic maculopathy stage 2, 0.8% (95% CI, 0.6%-10.0%); stage 3, 0.2% (95% CI, 0.1%-0.4%); and stage 4, 0.2% (95% CI, 0.1%-0.4%). The prevalence of moderate to severe vision impairment and blindness was 29.8% (14 of 47 participants; 95% CI, 16.2%-43.3%) in stage 2 myopic maculopathy, 57.1% (8 of 14 participants; 95% CI, 27.5%-86.8%) in stage 3, and 100% (13 of 13 participants; 95% CI, 100%-100%) in stage 4. In multivariable analysis, a higher myopic maculopathy prevalence was associated with longer axial length (odds ratio [OR], 4.54; 95% CI, 3.48-5.92; P < .001), older age (OR, 1.04; 95% CI, 1.01-1.07; P = .03), and thinner peripapillary retinal nerve fiber layer thickness (OR, 0.96; 95% CI, 0.95-0.98; P < .001). After exclusion of glaucomatous eyes, the association between myopic maculopathy prevalence and thinner retinal nerve fiber layer remained significant (OR, 0.96; 95% CI, 0.95-0.98; P < .001). Myopic maculopathy prevalence was not significantly associated with sex; region of habitation; level of education; ethnicity; prevalence of arterial hypertension, chronic obstructive pulmonary disease, chronic kidney disease, diabetes, and inflammatory liver disease; hearing loss; depression score; or anxiety score. CONCLUSIONS AND RELEVANCE In this ethnically mixed population from Russia, myopic maculopathy prevalence was mainly associated with elongated axial length and thinner peripapillary (continued)

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“…Myopic maculopathy was graded as suggested by the Meta-analysis for Pathologic Myopia Study Group. 4 Recent publications described the study design in detail. [9][10][11]…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of Myopic Maculopathy Among Adults in a Russian Population

et al. 2020

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“…Myopia is the most common refractive error worldwide, continuously advancing and spanning the entire literate world [1 -3]. Untreated, progressive myopia can lead to complications affecting vision, ocular alignment, and physiological blindness [4][5][6][7]. Genetic and environmental factors influence myopia occurrence and progression, and some seem to be closely linked to each other [8][9][10][11][12].…”

Section: Contributing Factors To Myopia Progressionmentioning

confidence: 99%

Peripheral Defocus and Myopia Management: A Mini-Review

Erdinest

London

Lavy

et al. 2023

Korean J Ophthalmol

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Myopia is the most common refractive error in the world, and its’ prevalence continually increases. The potential pathological and visual complications of progressive myopia have inspired researchers to study the sources of myopia, axial elongation, and explore modalities to arrest progression. Considerable attention has been given over the past few years to the myopia risk factor known as hyperopic peripheral blur, the focus of this review. The primary theories currently believed to be the cause of myopia, the parameters considered to contribute and influence the effect of peripheral blur, such as the surface retinal area or depth of blur will be discussed. The currently available optical devices designed to provide peripheral myopic defocus will be discussed, including bifocal and progressive addition ophthalmic lenses, peripheral defocus single vision ophthalmic lenses, orthokeratology lenses, and bifocal or multifocal center distance soft lenses, as well as their effectivity as mentioned in the literature to date.

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“…4 The definition of MMD is highly variable among studies but generally includes myopic retinal characteristics, such as tessellated fundus, lacquer cracks, myopic chorioretinal atrophy, and staphyloma. 5,6 Pathologic myopia is another frequently used concept and includes posterior staphyloma, myopic choroidal neovascularization (CNV), Fuchs spot, lacquer cracks, or myopic maculopathy equal to or more serious than diffuse choroidal atrophy. 7 Most of these features are directly related to axial length (AL) elongation and thinning of the retina, attenuation of the retinal pigment epithelium, and choroidal thinning.…”

mentioning

confidence: 99%

“…7 Most of these features are directly related to axial length (AL) elongation and thinning of the retina, attenuation of the retinal pigment epithelium, and choroidal thinning. 5,[8][9][10][11] The variability in classifications hindered direct comparisons, [12][13][14] but the Meta-analysis for Pathologic Myopia (META-PM) Study Group international grading system developed in 2015 changed the grading landscape by introducing a uniform classification for high myopia features. 5 A potential limitation of this system was that its development was primarily based on clinical data of Asian patients.…”

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confidence: 99%

Prevalence of Myopic Macular Features in Dutch Individuals of European Ancestry With High Myopia

et al. 2022

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High myopia incidence and prevalence is increasing worldwide, and the visual burden caused by myopia is expected to rise accordingly. Studies investigating the occurrence of myopic complications in individuals of European ancestry with high myopia are scarce, hampering insights into the frequency of myopic retinal complications in European individuals and their visual burden.OBJECTIVE To assess the frequency of myopic macular features in individuals of European ancestry with high myopia. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional analysis of the Dutch Myopia Study (MYST) and individuals with high myopia from the Rotterdam Study (RS) included 626 patients with high myopia (spherical equivalent of refractive error [SER] Յ−6 diopters [D] or axial length [AL] Ն26 mm) who underwent an extensive ophthalmic examination including multimodal retinal imaging. In addition to this combination of a population-based cohort study and mix-based high myopia study, a systematic literature review was also performed to compare findings with studies of individuals of Asian ancestry. EXPOSURES High myopia, age, and AL.MAIN OUTCOMES AND MEASURES Frequency of myopic macular and optic disc features: tessellated fundus, myopic macular degeneration (MMD), staphyloma, peripapillary intrachoroidal cavitation, peripapillary atrophy (PPA), and "plus" lesions (choroidal neovascularization, Fuchs spot, and lacquer cracks). RESULTSThe mean (SD) SER of the combined study population (MYST and RS) was −9.9 (3.2) D; the mean (SD) age was 51.4 (15.1) years, and 387 (61.8%) were women. The prevalence of MMD was 25.9% and increased with older age (P for trend <.001), lower SER (odds ratio [OR], 0.70; 95% CI, 0.65-0.76; P < .001), and higher AL (OR, 2.53; 95% CI, 2.13-3.06; P < .001). Choroidal neovascularization or Fuchs spot was present in 2.7% (n = 17), both lesions in 0.3% (n = 2), and lacquer cracks in 1.4% (n = 9). Staphyloma, PPA, and MMD were highly prevalent in visual impaired and blind eyes (frequency was 73.9% [20 of 27], 90.5% [19 of 21], and 63.0% [17 of 27] of unilateral blind eyes for MMD, staphyloma, and PPA, respectively). Seven previous studies in Asian populations reported a variable MMD frequency ranging from 8.3% to 64%, but frequencies were similar for comparable risk profiles based on age and SER. CONCLUSIONS AND RELEVANCEIn this cross-sectional study of a highly myopic Dutch population of European ancestry, myopic retinal features were frequent; were associated with age, SER, and AL; and occurred in all visually severely impaired eyes. The absence of treatment options for most of these retinal complications emphasizes the need for effective strategies to prevent high myopia.

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Understanding Pathologic Myopia

Cited by 13 publications

References 50 publications

Prevalence of Myopic Maculopathy Among Adults in a Russian Population

Prevalence of Myopic Maculopathy Among Adults in a Russian Population

Peripheral Defocus and Myopia Management: A Mini-Review

Prevalence of Myopic Macular Features in Dutch Individuals of European Ancestry With High Myopia

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