Retinal and macular disorders associated with high myopia

Abstract

The impact of myopia, an apparently benign oculardisease, may be larger than it seems. A greater understanding of the potentially blinding risks of myopia by ophthalmologists and optometrists may facilitate the screening and management of myopia-related ocular complications. Severe myopia may be associated with increased risks of ocular complications and the prevention of the onset of myopia or the progression of low myopia to high myopia is of most importance. Epidemiological studies have demonstrated increasedprevalence of peripheral retinal degenerations in association with high myopia and increased axial length. Among the different types of peripheral retinal degenerations in high myopia, lattice degeneration is the most important peripheral retinal degeneration which can predispose to rhegmatogenousretinal detachment (RRD). This is because retinal tearscan develop at the posterior and lateral margins of the lattice degeneration caused by strong vitreoretinaladhesions following posterior vitreous detachment. So, dilated fundus examination should be carried out in all myopic patients especially when refraction exceeds - 4D. When retinal degenerations were found in high myopic patient proper management should be followed according to severity of disorders and future planning for refractive surgery. Retinal breaks in highly myopic eyes are a huge risk for the occurrence of retinal detachment, which results in the decrease of vision and damage to other functions of sight. Retinal breaks may vary in shape and location. In the cases of diagnosed retinal breaks in one eye, it is recommended to also test the other, healthy eye. Bilateral retinal tears are often combined with their symmetric localization. The breaks can be located in various sectors and meridians of the fundus, including the macula. However, the upper temporal quadrant is considered to be the most frequent location of retinal breaks.