![]() 20 As such, it is fundamental to reduce myopia onset and progression to prevent future ocular complications. estimated that each 1 diopter increase in myopia is associated with a 67 percent increase of myopic maculopathy and that slowing myopia progression by 1 diopter should reduce the likelihood of MM by 40 percent. However, the key is that preventative therapy aiming to reduce ocular complications should be considered for all myopic patients. Prevention/Treatment Unfortunately, there is no established treatment for MM at this point. Note that lacquer cracks, CNV, and Fuch’s spot are considered to be the “plus” lesions. MM can be classified in the following five categories based on the International Photographic Classification and Grading System: 29Ĭategory 0: no myopic retinal degenerative lesionĬategory 2: diffuse chorioretinal atrophy It has also been shown that patients with macular atrophy, CNV, or Fuchs spot had worse BCVA compared with those with patchy or diffuse atrophy, lacquer cracks, or tessellated fundus. 31 Tessellated fundus, in contrast, did not affect BCVA. 11 Indeed, macular atrophy had the most significant impact on BCVA, followed by CNV, patchy atrophy, diffuse atrophy, or lacquer cracks. 29 As mentioned above, MM irreversibly reduces BCVA. It comprises stretched blood vessels, peripapillary atrophy, posterior staphyloma, diffuse, patchy macular atrophy with or without lacquer cracks, subretinal hemorrhages, choroidal neovascularization (CNV), Fuch’s spot, and chorioretinal atrophy. 25Ĭlinical Presentations MM is one of the earliest complications associated with myopia. On the other hand, MM does not seem to be associated with any major internal medical disease or level of education. In addition, older age, 12,13,18,21,25-27 reduced choroidal thickness, 28 and posterior staphyloma 29,30 are also considered to be risk factors for MM. also found that a higher MM prevalence was associated with longer axial length (OR, 4.54) in a Russian population-based study. Compared with patients with axial lengths below these values, patients with axial lengths above these values showed a significantly higher OR of MM (men: 21, women: 38). reported in a Japanese population that the optimal cutoff values for identifying MM were 25.9 mm and 25.3 mm in men and women, respectively. Risk Factors Not surprisingly, higher refractive error 18,21-23 and longer axial length 18,24,25 carry higher risks for MM. Therefore, while MM is more commonly seen in high myopic patients, moderate and even low myopia also significantly increase the risk of myopia maculopathy. conducted a meta-analysis on eight population-based studies and reported significantly increased odds ratio (OR) values for myopia (OR: 102 with all levels of myopia pooled, 845, 73, and 14 for high, moderate, and low myopia, respectively). 11 Specifically, the prevalence varied from 13.3 percent to 65.4 percent in high myopes, 0.3 percent to 7.8 percent in moderate myopes, and 0.1 percent to 7.0 percent in low myopes. Prevalence The prevalence of MM ranged from 0.2 percent to 4.0 percent in myopic patients. These most recent findings on MM review its prevalence, risk factors, clinical presentations (categories), prevention, and treatment. 10 With the speculation that half of the world population will be myopic in 2050 1, it is conceivable that this financial burden will worsen in the near future. reported the global productivity loss caused by MM to be $6 billion. MM poses a tremendous burden to patients, their families, and society. 9 It is estimated that, without changing the current interventions, up to 55.7 million people will have visual impairment, and up to 18.5 million people will be blind, due to MM in 2050. reported that in 2015 MM caused visual impairment in 10 million people and blindness in 3.3 million people worldwide. Myopic maculopathy (MM), also known as myopic macular degeneration, is the most serious, irreversible, vision-threatening complication and the leading cause of bilateral visual impairment and blindness. As a result, the World Health Organization recognizes that myopia, if not fully corrected, is a significant cause of visual impairment. 1 Myopia can cause a wide spectrum of complications, such as cataracts, glaucoma, retinal detachment, and myopia maculopathy. It has been estimated that 50 percent of the world population will be myopic in 2050, with 10 percent having high myopia. Myopia is currently a major public health concern because of its rapidly increasing prevalence worldwide and the threat to vision.
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