Myopia causes an estimated annual productivity loss of $244 billion and macular degeneration blindness is another serious burden that comes with myopia.

Current treatments cannot reverse or prevent progression of myopia; however, some methods have proven promising in slowing its advancement, including soft multifocal contact lenses and orthokeratology (ortho-k). We will explore these options further here.

High-risk retinal holes and retinal tears

Myopia (nearsightedness) can increase the risk of numerous eye conditions, including choroidal neovascularization and retinal holes, both of which are particularly dangerous in those with severe myopia. Myopic CNV often leads to progressive vision loss or legal blindness without treatment; myopic macular degeneration treatment may reduce this risk in such cases.

People with myopia are more susceptible to retinal tears and detachments due to physical stretching of the eye from having an elongated shape, increasing physical stretching as well as fluid tracking across a retinal hole leading to tears or detachments if left untreated; retinal detachments require immediate medical attention as leaving untreated can result in permanent blindness.

Nearly all retinal detachments require surgical intervention in order to return it back into its proper position. Two common procedures include scleral buckling and pneumatic retinopexy; both involve placing a flexible band (buckle) around your eye that presses against and holds together the retinal hole until scar tissue heals it over time.

Retinal tears may also result from posterior vitreous detachment (PVD). PVD is a normal part of aging in which the gel-like fluid that fills the eyeball becomes increasingly watery over time and pockets of liquid form within. As these pockets increase tension on the retinal-backwall interface of the eyeball, retinal tears may occur as a result.

Retinal tears can lead to flashes of light and vision disturbances that are difficult to detect until fluid travels through a retinal hole and detaches it from its surroundings. Retinal holes usually develop on either the peripheral (side) retina and are most frequently found among myopic eyes as their peripheral retinas tend to be thinner than in non-myopic ones.

Retinal tears and holes that are detected early, usually at an ophthalmologist’s office, can be treated using laser treatment. A doctor directs a beam of laser energy at the retinal tear to create rows of small burns which “tack-weld” it back together so it does not detach from its base. While your vision and/or floaters may temporarily increase after treatment with laser, typically these symptoms improve within hours.

Macular neovascularisation

Myopia (near-sightedness) can lead to several degenerative changes in the eye and retina, including choroidal neovascularisation – when new blood vessels form on the choroid that leak or bleed into the retina – leading to macular neovascularisation (CNV) that eventually leads to uncorrectable central vision loss in some cases. Anti-VEGF therapy has proven helpful in slowing its progress and improving visual acuity among myopic CNV patients.

Researchers recently conducted an in-depth examination of long-term outcomes of bevacizumab treatment on an extensive cohort of eyes with neovascular age-related macular degeneration, treated with bevacizumab injection. They observed that initial improvements to best corrected visual acuity did not persist over the 10-year follow up, and myopic CNV recurrences were associated with patchy chorioretinal atrophy and subfoveal drusen formation despite similar rates of BCVA decline to non-recurrent eyes.

Numerous risk factors increase the chance of myopic CNV, such as age, pathological myopia and high myopia. Pathological myopia occurs when eyes become abnormally elongated through physical stretching of sclera, choroid and retina resulting in changes such as choroidal neovascularisation and macular degeneration.

Wet age-related macular degeneration (WARMD), the most severe form of neovascular AMD, is characterized by abnormal, leaky choroidal blood vessels leaking through Bruch’s membrane and under the retina. These new blood vessels may appear either classic CNV or occult CNV on fluorescein angiography: classic CNV typically exhibits well-demarcated areas with increased dye accumulation while occult CNV has less distinct areas and often does not show dye uptake during fluorescein angiography tests; while classic CNV displays well-defined areas with increased dye accumulation while occult CNV does not show dye uptake due to not showing uptake on fluorescein angiography.

Ranibizumab was shown to be effective in treating wet age-related macular degeneration with classic choroidal neovascularization in people with myopia, in a previous clinical trial. While its results are promising, more research needs to be conducted on its long-term safety and efficacy when used against myopic CNV; further investigation should also take place into how they relate to macular atrophy for better assessment of anti-VEGF agents such as bevacizumab or others.

Atrophic changes

High myopia can result in retinal thinning and the subsequent formation of retinal holes, potentially leading to retinal detachment and detachment symptoms in some individuals. When this occurs, patients will typically notice shadowed parts of their visual field or that an area has gone black, necessitating emergency ophthalmological care as soon as possible due to potential risk of retinal detachment which can be very dangerous.

Myopic macular degeneration holes often appear as yellow-orange lesions on the periphery of the retina, visible on retinal scans such as OCT or MRI and detectable through clinical exams. Additional symptoms of myopic macular holes include sudden peripheral vision loss, shadow vision or seeing something moving across their vision field; sudden loss of peripheral vision when looking through glasses; an unusual sensation while gazing upon objects from far distance and dark rings at the center of one’s eyeball – these all indicate myopic macular holes which should be evaluated immediately as these could result in retinal breaks and detachments requiring surgical repair or even complete loss of vision altogether.

Myopic macular degeneration may also result in choroidal neovascularization, characterized by subretinal hemorrhages and deposits of fatty protein (elastin) on the retinal surface resulting in subretinal hemorrhages and deposits of elastin on its surface that could eventually lead to permanent vision loss.

One study demonstrated that myopic macular degeneration eyes experienced increasing rates of choroidal neovascularization (CNV), suggesting an inverse relationship between refractive error and axial length and CNV growth. According to this finding, better methods must be utilized for measuring refractive error and length such as using cycloplegic autorefraction for measurement purposes.

Recent clinical data involving myopic macular degeneration treatment showed that soft multifocal contact lenses can significantly slow progression of myopia by reshaping cornea. Furthermore, children who wore such lenses experienced significantly lower rates of progression in both axial length and refractive error than those not wearing them.

Recent clinical research on myopic macular degeneration patients who received anti-VEGF therapy found that the drug significantly reduced incidences of fibrosis, atrophy, macular hole and longitudinal BMVA over five years. Furthermore, researchers also analyzed factors like axial length, peripheral atrophy area (PPA), tilt ratio and macular choroidal thickness on this incidence.

Retinal detachment

Retinal detachments are serious medical emergencies that could potentially lead to blindness unless promptly treated. The retina is an eye tissue responsible for turning light into electrical impulses that travel to the brain as images, connected by fine fibers to its supporting layer (choroid). When separated from its supporting tissue (choroid), however, its function ceases to function correctly – flashes of light or curtained or shadowy images appearing suddenly can indicate retinal detachment symptoms; so if these occur quickly seek medical advice immediately from THIRDCOAST RETINA’s experts at THIRDCOAST RETINA as soon as possible!

Myopia can increase your risk of retinal detachment as the layer separating the retina from nearby blood vessels becomes thinner in people with myopia, potentially allowing blood vessels to break into it and leak fluid, leading to detachment and fluid leakage. Myopic choroidal neovascularisation may also contribute to retinal detachment.

If retinal tears or detachments are caught early and treated, 85% of detached retinas can be successfully reattached. Surgery procedures may include draining vitreous fluid from under the retina, sealing retinal tears with laser light, and inserting an intraocular gas bubble as an internal splint; or alternatively your doctor can use freezing treatments to induce controlled scarring around it in order to seal it shut.

Preventing myopia from progressing is crucial if you wish to avoid retinal detachments or other eye issues, including blind spots. Your doctor can suggest an individualized care plan including appropriate outdoor activities and limiting close tasks like reading or driving; in addition, avoiding excessive eye rubbing or thick contact lenses may reduce myopia progression and risk. If you already have myopia, be sure to schedule regular dilated exams and high-definition photographs with your eye care provider.