Strategies for the Prevention and Control of Complications of Pathological Myopia: A Systematic Review of Research Progress from Axial Control to Target Organ Protection

Abstract

Pathological myopia (PM) is one of the leading causes of irreversible vision impairment and blindness worldwide, characterized by progressive excessive elongation of the eyeball and a series of fundus complications, posing a serious threat to visual health. This review systematically analyzes the evolution and progress of prevention and control strategies for complications in this field based on the latest research literature from 2021 to 2025. The current prevention and control concept has evolved from simply controlling axial elongation to emphasizing comprehensive protection of target organs such as the retina, choroid, and optic nerve. This review provides an in-depth analysis of the latest evidence and efficacy of pharmacological interventions (such as low-concentration atropine), optical interventions (such as specially designed frame glasses and orthokeratology lenses), behavioral interventions, and emerging targeted treatments (such as anti-VEGF drugs and gene therapy) in delaying axial elongation and preventing complications. It also explores the crucial role of multimodal imaging assessment and artificial intelligence risk prediction models in developing personalized prevention and control plans, and looks ahead to future research directions for achieving integrated management from “axial control” to “target protection”, aiming to provide evidence-based support for clinical practice.