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Myopic Maculopathy

Myopic Maculopathy - What it is

If you have high degree myopia (short-sightedness) of over 600 degrees, you may be at risk of pathologic myopia. 

What is pathologic myopia and myopic maculopathy?
Patients with short sightedness of over 600 degrees are classified as having high myopia. Myopia occurs when the eyeball is too long and light rays entering the eye are unable to focus on the light-sensitive part of the eye called the retina. (Find out more about myopia)

In high myopia, excessive elongation of the eyeball results in a risk of degeneration of the retina, in particular, to a central part of the retina called the macula. The macula has the highest concentration of cones (light sensitive cells that interpret colour images) in the retina and plays a central role in processing detailed images. (Read more on how the eye works)

Highly myopic eyes are at increased risk of pathologic myopia, a sight-threatening condition characterised by degeneration (myopic macular degeneration), stretching of the retinal layers (myopic retinoschisis) and bleeding in the macula (choroidal neovascularisation).

Myopic Maculopathy - Symptoms

There may be vision loss or distortion of vision. This can occur acutely or slowly over a long period of time.

Fundus photo showing bleeding and oedema over the macular region of a highly myopic eye

Fluorescein angiography showing subretinal blood clot and accumulation of fluid over the macular region

Fundus photo showing severe degeneration of the macula in a highly myopic eye. The black arrows point to areas where there is complete loss of retinal tissue and its underlying blood supply (choroid).

Myopic Maculopathy - How to prevent?

There is currently no treatment to prevent myopic maculopathy. However, there are several treatments being studied in the research setting to halt eye elongation and prevent formation and progression of myopic maculopathy.

Myopic Maculopathy - Causes and Risk Factors

For general myopia, studies have shown that a strong family history of short-sightedness and not enough time outdoors during youth are risk factors of myopia. The higher the level of myopia, the greater the likelihood of forming pathologic myopia, outpouchings (staphyloma) in the back wall of the eye, and myopic maculopathy.

Myopic Maculopathy - Diagnosis

Myopic maculopathy is diagnosed by careful examination by an ophthalmologist. It is supplemented by detailed imaging geared toward assessing for subtle thinning of the retina as well as the underlying blood layer (choroid) and deformability of the eye wall (sclera).

Myopic Maculopathy - Treatments

Treatment for myopic maculopathy depends on the type of problem that arises. For example, choroidal neovascularisation can be treated with intravitreal injections of anti-VEGF (vascular endothelial growth factors).  For myopic foveoschisis (with foveal detachment) and macular hole, the treatment of choice is surgery including vitrectomy, membrane peel and intraocular gas.

Myopic Maculopathy - Preparing for surgery

If warranted, preparation for surgery is similar to that done prior to any vitrectomy surgery (hyperlink to section on retinal detachment).

Myopic Maculopathy - Post-surgery care

If warranted, post-surgical care after vitrectomy surgery would be similar to that described in the retinal detachment section. Repair of myopic foveoschisis (with foveal detachment) and  myopic macular holes would usually require a face-down position to allow the intraocular gas to perform its function and help the repair’s success.

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth