Pathologic Myopia

Type of myopia that begins during childhood and progressively worsens, resulting in severe myopia by adulthood with an axial length >/= 26mm or refractive error >/= -6.00D)

Aetiology

  • Environmental and genetic influences cause increased axial growth of the eyeball
  • Often accompanied by degenerative changes in the retina
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Clinical presentation

Symptoms

  • Blurred vision

Signs

  • Scleral thinning

Investigations

Fundoscopy

  • Lacquer cracks
  • Subretinal haemorrhage
  • Fuschs' spot - degeneration of the macula; occurs due to proliferation of RPE associated with choroidal haemorrhage
  • Posterior staphyloma - outpouching of scleral tissue typically involving the optic disc or macula
  • RPE/choroid atrophy
  • Degeneration - cystoid, paving stone, lattice
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Fluorescein angiography

  • Useful for evaluating myopic patients for development of choroidal neovascularization (CNV)
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Management

  • Annual checkups if stable
  • If CNV develops - anti-VEGF