Prevalence and progression of myopic retinopathy in an older population

Fan

et al. 2006

Eye

Purpose To evaluate the prevalence and factors associated with posterior pole and peripheral retinal lesions in Chinese subjects with high myopia. Methods Three hundred and thirty-seven asymptomatic adults with high myopia of refractive error pÀ6 D were examined in a cross-sectional community-based study. All subjects underwent cycloplegic refraction, ultrasound biometry and dilated fundal examination. Statistical analysis was performed to assess factors associated with the presence of posterior pole and peripheral retinal lesions. Results The mean age of the 337 subjects was 36.0 years and the mean spherical equivalent refractive error was À10.2 D. Thirty-eight eyes (11.3%, 95% CI ¼ 8.1-15.2%) were found to have one or more posterior pole lesions and subjects with posterior pole lesion had significantly older age, longer axial length and higher degree of myopia (all Po0.001) compared with subjects without posterior pole lesion. After controlling for axial length, both the severity of refractive error and older age were significantly associated with the presence of posterior pole lesion (both Po0.001). For peripheral retinal lesions, 189 eyes (56.1%, 95% CI ¼ 50.6-61.5%) were found to have one or more peripheral retinal lesions. The presence of peripheral retinal lesion was associated with younger age and higher degree of refractive error (P ¼ 0.046 and 0.002, respectively). Conclusion Posterior pole and peripheral retinal degenerative lesions were found in a considerable proportion of subjects with high myopia. As some of these retinal lesions might predispose to visual impairment, highly myopic individuals should be educated on the symptoms of various eye conditions and seek care immediately if symptoms arise.

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Peripheral and posterior pole retinal lesions in association with high myopia: a cross-sectional community-based study in Hong Kong

Fan

et al. 2006

Eye

“…[17][18][19][20] These degenerative changes substantially increase the risk of loss of vision and indeed in countries where the prevalence of myopia is high, MMD has been identified as one of the leading causes of visual impairment and blindness. MMD was the most frequent cause of visual impairment and blindness in a population of elderly Chinese in Taiwan 21 and a pilot assessment of Hong Kong Chinese residents aged 40 and over found myopic choroidal degeneration to be the leading cause for impaired vision (o20/60 visual acuity).…”

Section: Blindness Due To Myopiamentioning

confidence: 99%

Myopia, an underrated global challenge to vision: where the current data takes us on myopia control

Holden

Sankaridurg

Smith

et al. 2013

Eye

207

153

Myopia is the most frequent cause of distance impairment in the world and is creating an alarming global epidemic with deleterious ramifications for the quality of life and economic health of individuals and nations as a whole. In addition to being immediately disadvantageous, myopia increases the risk of serious disorders such as myopic macular degeneration, retinal detachment, glaucoma, and cataract and is a leading cause of visual impairment and blindness across many countries. The reduction in age of onset of myopia is of great concern since the earlier the onset, the more myopic the individual will become, with all the attendant increased risks of accompanying debilitating eye conditions. The economic burden is great; both in consequences of uncorrected refractive error and also in the provision of devices for correcting visual acuity. Earlier onset of myopia increases the lifetime economic burden related to loss of productivity and independence, leading to a reduced quality of life. Recent data suggest addressing accommodation per se has little direct amelioration of myopia progression. Pharmacological interventions that effect changes in the sclera show promising efficacy, whereas optical interventions based on a myopic shift in the retinal image are proving to effect up to 55% reduction in the rate of progression of myopia. Early contact lens and spectacle interventions that reduce the rate of progression of myopia are able to significantly reduce the burden of myopia. These nonpharmacological interventions show profound promise in reducing the overall associated morbidity of myopia.

“…[7][8][9] In the Handan Eye study of 6830 participants of age 30 years or older, myopic maculopathy was found in 84 individuals giving a person-specific prevalence of 0.9%. 7 Using the same method of ascertainment, in the Beijing Eye study, the prevalence of myopic maculopathy in 4439 adults older than 40 years was found to be much higher at 3.1%.…”

Section: Myopic Maculopathymentioning

confidence: 99%

Myopic foveoschisis: a clinical review

Gohil

Sivaprasad

Han

et al. 2015

Eye

To review the literature on epidemiology, clinical features, diagnostic imaging, natural history, management, therapeutic approaches, and prognosis of myopic foveoschisis. A systematic Pubmed search was conducted using search terms: myopia, myopic, staphyloma, foveoschisis, and myopic foveoschisis. The evidence base for each section was organised and reviewed. Where possible an authors' interpretation or conclusion is provided for each section. The term myopic foveoschisis was first coined in 1999. It is associated with posterior staphyloma in high myopia, and is often asymptomatic initially but progresses slowly, leading to loss of central vision from foveal detachment or macular hole formation. Optical coherence tomography is used to diagnose the splitting of the neural retina into a thicker inner layer and a thinner outer layer, but compound variants of the splits have been identified. Vitrectomy with an internal limiting membrane peel and gas tamponade is the preferred approach for eyes with vision decline. There has been a surge of new information on myopic foveoschisis. Advances in optical coherence tomography will continually improve our understanding of the pathogenesis of retinal splitting, and the mechanisms that lead to macular damage and visual loss. Currently, there is a good level of consensus that surgical intervention should be considered when there is progressive visual decline from myopic foveoschisis.