Understanding pathologic myopia

Abstract

Fundus complications due to pathologic myopia are a major cause of visual impairment and blindness worldwide, especially in East Asian countries. The patients with pathologic myopia develop loss of the best-corrected vision due to various lesions occurring in the macula and the optic nerve. In the META-PM (meta analyses of pathologic myopia) study classification, pathologic myopia has been defined by the presence of myopic chorioretinal atrophy equal to or more serious than diffuse atrophy and/or the presence of posterior staphyloma. In addition, the advent of new imaging technologies, such as optical coherence tomography (OCT), ultra wide-field OCT, and three-dimensional magnetic resonance imaging (3D MRI) has enabled the detailed observation of various pathologies specific to pathologic myopia. In addition, new pathology such as dome-shaped macula has been clarified. Therapeutic approaches such as intravitreal injections of anti-vascular endothelial growth factor agents and the vitreoretinal surgeries for myopic macular retinoschisis have greatly improved the prognosis of patients with pathologic myopia. In the future, therapies targeting staphylomas are expected.