Degenerative Myopia

Ward, Brian

doi:10.1097/iae.0b013e31826d3a93

Cited by 19 publications

(6 citation statements)

References 4 publications

(5 reference statements)

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“…What creates conditions for the development of myopia and why myopia progresses in some individuals and not in others remain important topics of further research. Several treatment options for myopia, such as optical correction using spectacles, multifocal contact lenses, or atropine, are available, but efficacy is limited [ 66 – 72 ]. The identification of drug targets and the development of suitable drugs that can be used to suppress or possibly even reverse the progression of myopia require a deeper understanding of the signaling pathways underlying the ocular response to optical defocus of different signs.…”

Section: Discussionmentioning

confidence: 99%

Gene expression in response to optical defocus of opposite signs reveals bidirectional mechanism of visually guided eye growth

et al. 2018

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Myopia (nearsightedness) is the most common eye disorder, which is rapidly becoming one of the leading causes of vision loss in several parts of the world because of a recent sharp increase in prevalence. Nearwork, which produces hyperopic optical defocus on the retina, has been implicated as one of the environmental risk factors causing myopia in humans. Experimental studies have shown that hyperopic defocus imposed by negative power lenses placed in front of the eye accelerates eye growth and causes myopia, whereas myopic defocus imposed by positive lenses slows eye growth and produces a compensatory hyperopic shift in refractive state. The balance between these two optical signals is thought to regulate refractive eye development; however, the ability of the retina to recognize the sign of optical defocus and the composition of molecular signaling pathways guiding emmetropization are the subjects of intense investigation and debate. We found that the retina can readily distinguish between imposed myopic and hyperopic defocus, and identified key signaling pathways underlying retinal response to the defocus of different signs. Comparison of retinal transcriptomes in common marmosets exposed to either myopic or hyperopic defocus for 10 days or 5 weeks revealed that the primate retina responds to defocus of different signs by activation or suppression of largely distinct pathways. We also found that 29 genes differentially expressed in the marmoset retina in response to imposed defocus are localized within human myopia quantitative trait loci (QTLs), suggesting functional overlap between genes differentially expressed in the marmoset retina upon exposure to optical defocus and genes causing myopia in humans. These findings identify retinal pathways involved in the development of myopia, as well as potential new strategies for its treatment.

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Section: Discussionmentioning

confidence: 99%

Gene expression in response to optical defocus of opposite signs reveals bidirectional mechanism of visually guided eye growth

et al. 2018

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“…Other factors implicated in the pathogenesis are anteroposterior traction caused by the vitreous cortex, tangential forces due to the epiretinal membranes (ERMs) or the internal limiting membrane (ILM), and the stretched retinal arteries [2]. …”

Section: Introductionmentioning

confidence: 99%

A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment

Bedda

Hadi

Lolah

et al. 2017

Journal of Ophthalmology

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Purpose. To report the anatomic and visual results of a new sutureless illuminated macular buckle designed for patients with macular hole retinal detachment related to high myopia (MMHRD). Design. Prospective nonrandomized comparative interventional trial. Methods. Twenty myopic eyes of 20 patients (mean age, 51.4 years; range, 35–65 years) presenting with MMHRD with a posterior staphyloma, in whom the new buckle was used, were evaluated. The buckle used was assembled from a 5 mm wide sponge and a 7 mm wide silicone tire; it was fixed utilizing the sterile topical adhesive Histoacryl Blue (B Braun, TS1050044FP) which polymerizes in seconds upon being exposed to water-containing substances. The primary outcomes measured included aided visual acuity (BCVA) and optical coherence tomography (OCT) findings. The mean follow-up period was 6 months. Results. Postoperatively, the MH closure was identified by OCT in 8 (40%) eyes. The mean BCVA increased from 0.11 to 0.21 (p < 0.005). The axial length of the eyes included decreased from 30.5 mm preoperatively to 29.8 mm (p = 0.002) postoperatively. Conclusion. Preparation of the new sutureless macular buckle is simple and easy. Illumination of the terminal part of the buckle ensures proper placement. Histoacryl Blue is effective in fixing the buckle in its place for at least 6 months with no reported intra- or postoperative complications.

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“…Even though the disappointing late consequences of progressive high myopia are familiar to all eye care professionals, most of them look at the disease as a "lost cause" and let it run its natural course; PSR is scarcely considered as a therapeutic option [4]. Its availability has become rather limited worldwide by now.…”

Section: Discussionmentioning

confidence: 99%

“…This is equally true for the "myopia epidemic". As Brian Ward put it, ophthalmologists ought to significantly change their attitudes towards the potentially blinding condition of progressive high myopia and be "farsighted in nearsightedness" [4].…”

Section: Discussionmentioning

confidence: 99%

“…Due to the excessive axial elongation, mechanical stretching and thinning of all three layers of the eye occurs, and this leads to the formation of vision-threatening degenerative lesions on the retina, i.e., pathological myopia with age. The consecutive visual disability very often affects individuals already in their productive years [4]. The biomechanically weak scleral tissue is, accordingly, the primary treatment target in early-onset high myopia to control pathological axial elongation early in the course of the disease, yet before the onset of vision-threatening degenerative lesions [10].…”

Section: Introductionmentioning

confidence: 99%

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Results with Posterior Scleral Reinforcement for Progressive Highly Myopic Children in Hungary

Széll

Boross

Facskó

et al. 2021

Klin Monbl Augenheilkd

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Purpose We have been performing posterior scleral reinforcement in our ophthalmological department since 1992 on progressive highly myopic eyes. Here, we report on our results with this technique in the foregoing 7 years in a retrospective comparative design. Methods Thirty-eight eyes of 32 patients, operated according to Snyder-Thompsonʼs method, were enrolled in this study, and a control group of 9 age- and myopia-matched childrenʼs 14 eyes was built for comparison. Pre- and postoperative best-corrected visual acuity, subjective refractive error (spherical equivalent of spectacle dioptres), and axial length were recorded. Changes within groups were calculated, as well as baseline parameters and their changes during follow-up, and compared between the groups. Correlation analysis was performed to identify factors that could influence myopia progression. Results Myopic progression was significantly lower in the operated than in the nonoperated group, both in terms of mean annual axial length as well as refractive error changes (0.21 ± 0.08 mm versus 0.49 ± 0.19 mm and 0.18 ± 0.29 D versus 0.6 ± 0.33 D, respectively). Mean overall visual improvement was more explicit in operated eyes as compared to those left untreated (0.15 ± 0.09 versus 0.01 ± 0.1). No association of any factor with myopia progression could be identified. We encountered no serious or lasting complications. Conclusion In our clinical practice, posterior scleral reinforcement according to Snyder-Thompson proved to be a safely applicable and effective surgical method to stop or significantly retard pathological increases in axial length and dioptres, and thus can help prevent the onset of myopic degenerative lesions, and irreversible visual impairment in the long run.

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Degenerative Myopia

Cited by 19 publications

References 4 publications

Gene expression in response to optical defocus of opposite signs reveals bidirectional mechanism of visually guided eye growth

Gene expression in response to optical defocus of opposite signs reveals bidirectional mechanism of visually guided eye growth

A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment

Results with Posterior Scleral Reinforcement for Progressive Highly Myopic Children in Hungary

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