Extreme Choroidal Thinning in High Myopia

Pang, Claudine E.; Sarraf, David; Freund, K. Bailey

doi:10.1097/iae.0000000000000368

Cited by 32 publications

(13 citation statements)

References 44 publications

(70 reference statements)

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“…The results of our study are in concordance with the results of a recent study by Pang et al. () who reported no significant reduction in VA (mean VA = 20/30) in highly myopic eyes (mean AL = 30.7 mm) with extreme choroidal thinning (mean subfoveal CT = 14 ± 6 μm), suggesting CT alone is not a reliable indicator of visual function. However, their study involved relatively small sample size (36 eyes of 20 myopic subjects) and older subjects (mean age of 71 years) with ocular comorbidities, and thus, their results may be complicated by confounding factors.…”

Section: Discussionsupporting

confidence: 92%

Choroidal thickness does not predict visual acuity in young high myopes

Gupta

Cheung

Saw

et al. 2016

Acta Ophthalmologica

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Section: Discussionsupporting

confidence: 92%

Choroidal thickness does not predict visual acuity in young high myopes

Gupta

Cheung

Saw

et al. 2016

Acta Ophthalmologica

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“…It is well-known that the choroid in highly myopic eyes is thinner compared with normal eyes. 7,87,112,113,136,[272][273][274][275][276][277][278][279][280][281][282][283][284][285][286] In eyes with pathologic myopia (defined as myopic eyes equal to or more serious than diffuse atrophy), the thinning of the choroid is extreme. In many cases, almost the entire thickness of the choroid disappears with sporadically remaining large choroidal vessels.…”

Section: Key Oct Features Determining Pathologic Myopiamentioning

confidence: 99%

IMI Pathologic Myopia

Ohno‐Matsui

Yamashiro

et al. 2021

Invest. Ophthalmol. Vis. Sci.

185

159

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Pathologic myopia is a major cause of visual impairment worldwide. Pathologic myopia is distinctly different from high myopia. High myopia is a high degree of myopic refractive error, whereas pathologic myopia is defined by a presence of typical complications in the fundus (posterior staphyloma or myopic maculopathy equal to or more serious than diffuse choroidal atrophy). Pathologic myopia often occurs in eyes with high myopia, however its complications especially posterior staphyloma can also occur in eyes without high myopia. Owing to a recent advance in ocular imaging, an objective and accurate diagnosis of pathologic myopia has become possible. Especially, optical coherence tomography has revealed novel lesions like dome-shaped macula and myopic traction maculopathy. Wide-field optical coherence tomography has succeeded in visualizing the entire extent of large staphylomas. The effectiveness of new therapies for complications have been shown, such as anti-VEGF therapies for myopic macular neovascularization and vitreoretinal surgery for myopic traction maculopathy. Myopia, especially childhood myopia, has been increasing rapidly in the world. In parallel with an increase in myopia, the prevalence of high myopia has also been increasing. However, it remains unclear whether or not pathologic myopia will increase in parallel with an increase of myopia itself. In addition, it has remained unclear whether genes responsible for pathologic myopia are the same as those for myopia in general, or whether pathologic myopia is genetically different from other myopia.

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“…We were not able to identify any clinical or multimodal imaging features of choroidal neovascularization that can indicate the underlying cause (AMD versus HM) of the NV. However, the presence of a very thin choroid (i.e., leptochoroid) 32 associated with signs of myopic maculopathy, such as lacquer cracks, may provide clues to the diagnosis of myopic NV and may indicate the need for axial length measurement. Myopic NV even in older patients, as in our study, does not require as aggressive a regimen of anti-VEGF therapy as in the typical AMD population.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Phenotypes of Age-Related Macular Degeneration in Eyes With High Myopia

Corbelli

Parravano

Sacconi

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To analyze the frequency and phenotypic variation of AMD in subjects with high myopia (HM), and to describe the clinical course and response to treatment of neovascularization (NV). METHODS. Patients with HM were identified at five retina tertiary referral centers. Inclusion criteria were myopic patients aged 55 years or more with axial lengths equal or greater than 25.5 mm. RESULTS. A total of 874 eyes from 442 HM subjects older than 55 years were identified and 104 eyes of 54 patients (72 6 11 years) were included in the study and followed up for 23.5 6 19.5 months. The estimated AMD frequency in HM subjects over 55 years was 11.9% (95% confidence interval; 9.8%-14.0%). A total of 34 of 104 eyes were diagnosed with drusen, 22 with reticular pseudodrusen (RPD), 28 with both drusen and RPD, and 20 with geographic atrophy. Neovascularization was detected in 52 eyes (50%), and type 1 was the most frequent form (39 eyes, 75%). Overall, NV was treated with 4.6 6 2.6 anti-VEGF injections. Eyes with treatment-naïve NV at baseline (n ¼ 34) required 3.8 6 1.5 anti-VEGF injections during the first year of treatment. This exceeded the injection number in the purely myopic population (1.8 to 3.6 injections for the first year). CONCLUSIONS. This study provides evidence to suggest that older patients with HM are at a significant risk of the dry and neovascular forms of AMD. NV in eyes with HM and AMD required more injections in the first year compared to NV in HM eyes without AMD.

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Extreme Choroidal Thinning in High Myopia

Cited by 32 publications

References 44 publications

Choroidal thickness does not predict visual acuity in young high myopes

Choroidal thickness does not predict visual acuity in young high myopes

IMI Pathologic Myopia

Prevalence and Phenotypes of Age-Related Macular Degeneration in Eyes With High Myopia

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