Based on 3D-MRI images of the eye, they showed that the difference in the ocular shape is correlated with the development of vision-threatening conditions in eyes with pathologic myopia. recently analyzed the shape of the whole eye, 5, 101, 102 so that even large posterior staphylomas could be imaged entirely ( Fig. 6). 30 This finding suggested the possibility that children who eventually develop pathologic myopia may be different, even at an early age.Īpplying three-dimensional (3D)-MRI, Moriyama et al. 29 However, a long-term follow-up study showed that 83% of adults with pathologic myopia and myopic maculopathy had already had diffuse choroidal atrophy around the optic disc in their childhood. Myopic maculopathy is rare in children with high myopia. 27, 28 In the Taiwanese elderly population, myopic maculopathy increased from 2.2% in individuals aged 65 years to 14.8% in relatively older adults. Pathologic myopia changes with chorioretinal atrophy were found in 52.9% and 19.3% of the Chinese and Singaporean adult groups with high myopia, respectively. In individuals with high myopia aged 40 years or older, a progressive increase was noted in the prevalence and severity of maculopathy. 19 The prevalence of pathologic myopia is low in children and adolescents, but increases with advancing age. The prevalence of myopic maculopathy increased and exponentially with increasing spherical equivalent and age in Singapore. In addition to the degree of myopia, age is an important factor in the development of pathologic myopia. 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. However, it remains unclear whether or not pathologic myopia will increase in parallel with an increase of myopia itself. In parallel with an increase in myopia, the prevalence of high myopia has also been increasing. Myopia, especially childhood myopia, has been increasing rapidly in the world. 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. Wide-field optical coherence tomography has succeeded in visualizing the entire extent of large staphylomas. Especially, optical coherence tomography has revealed novel lesions like dome-shaped macula and myopic traction maculopathy. Owing to a recent advance in ocular imaging, an objective and accurate diagnosis of pathologic myopia has become possible. Pathologic myopia often occurs in eyes with high myopia, however its complications especially posterior staphyloma can also occur in eyes without 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 is distinctly different from high myopia. Pathologic myopia is a major cause of visual impairment worldwide.
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