Myopic Macular Degeneration: Who, What, Where and How?

Myopic Macular Degeneration

Table of Contents

Due to the elongation of the eye, those with excessive myopia run the risk of developing irreversible degenerative alterations to the retina.  

What is myopic macular degeneration? 

Due to the eyeball’s elongation from being very short-sighted, myopic macular degeneration, or MMD, can happen. Tears in the macula region might occur as a result of the retina being stretched by the elongation of the eye. Additionally, it may result in hemorrhage under the retina or continuous retinal or macular atrophy. 

What is myopia or near-sightedness?  

Short-sightedness or near-sightedness are other names for myopia. When the eyeball becomes too lengthy, myopia develops. This indicates that your eye cannot focus light onto the retina. As a result,  your vision is clear up close but hazy in the distance. It’s a very common eye condition.  However, most people can see clearly with contact lenses or glasses. 

Diopters are a unit used to quantify the strength of spectacles or contact lenses used to remedy blurry vision (D). Therefore, the greater the number, the more near-sighted your vision is.  A person with a prescription over -6.00 would be considered to have high myopia.   

Myopia related problems 

Pathological myopia can develop in people with excessive myopia. Because of the elongation of the eye,  persistent degenerative alterations to the retina might take place. The macula may experience any of these degenerative conditions. It is known as myopic macular degeneration. 

Among these degenerative conditions are: 

Atrophy of the retina

Myopia causes the retina to be stretched, making it thinner, which can result in regions of retinal atrophy (breakdown) and accompanying visual loss. Anywhere on the retina can experience retinal atrophy. Center vision may be impacted if it occurs in the macula’s central region. 

Lacquer cracks 

Bruch’s membrane, a layer that lies between the retina and the choroid, may crack when the eye is stretched. The macula may also experience these fractures. The term for them is lacquer cracks. Also possible is a relationship between lacquer cracks and choroidal neovascularization. Even in the absence of choroidal neovascularization, retinal hemorrhages are still possible. 

Choroidal neovascularisation (CNV)

The macula may be affected by new blood vessels that develop in atrophy- or lacquer-cracked regions. The term for this is “choroidal neovascularization” (CNV). The delicate, permeable walls of the developing blood vessels can break and might cause scarring and visual loss.

Retinal Detachment (RD) 

Due to eye elongation and consequent retinal thinning and stretching, those with extreme myopia are more likely to have retinal detachments. The abrupt development of flashes and floaters is one of the most typical symptoms. Others may have blurred or diminished vision, as well as a curtain or shadow in the afflicted eye. Retinal tears are often treated with laser surgery, but retinal detachments are typically treated surgically.

Who is most susceptible to Myopic Macular Degeneration? 

While MMD only affects roughly 3% of individuals worldwide, myopia itself is a rather prevalent condition. 

More research is required to pinpoint the precise root causes of MMD, however, researchers currently believe that it is a result of a mix of genetic and environmental factors. 

There are certain established risk factors for this disorder, though:  

High Myopia

High-grade myopia is considered for people with a prescription strength exceeding -6.00. Any prescription strength of more than -10.0 is regarded as pathological myopia and has an even greater risk.

Family

High-grade myopia and MMD frequently run in families, and pathological myopia can occasionally be identified in young patients. 

Ethnicity

In Asia, MMD is more frequently observed. Chinese Americans and those with Japanese heritage are also at higher risk of getting the illness, according to an older 2009 research report. 

Myopic Macular Degeneration Symptoms

Initially, you might not have any MMD symptoms. 

It takes time for the illness to worsen, so you might not immediately experience any symptoms. When symptoms do materialize, they may comprise: 

  • eyesight is warped 
  • wavy lines in your eyesight and deteriorating vision over time 
  • difficulties seeing in weak light, blank patches in your eyesight, and problems adapting to light 
  • Some symptoms may be difficult to identify from common vision problems since the disorder typically affects patients who already have high-grade myopia. 
  • It’s crucial to have an eye exam at least once a year and to speak with a doctor if you have any questions or concerns about your vision.

Myopic Degeneration vs Macular Degeneration

While there are some similarities between this disease and age-related macular degeneration (AMD), they are not the same. 

Both diseases can lead to visual loss and have many of the same symptoms. Both have a connection to the slow deterioration of the macula in your eyes. 

However, MMD is connected to heredity and high-grade myopia, whereas AMD is related to aging as you get older. It frequently begins considerably earlier than AMD, which normally affects people over the age of 65.

Vitamins for myopic macular degeneration

Although vitamins are an important item in the treatment and prevention of age related macular degeneration. They don’t play the same role in myopic macular degeneration due to the underlying cause of this disease. Taking a good ocular vitamin is always a good idea to prevent AMD however because the two diseases are not mutually exclusive.

Treatment for myopic macular degeneration

Although there is no cure for this eye problem, if you do not have any signs of vision loss, you might be able to wear glasses or contact lenses to correct your nearsightedness. By redirecting the way light strikes your retina, either solution can improve vision. 

Some MMD side effects that may require treatment for you include: 

  • If you have retinal atrophy, wearing safety glasses while engaging in certain activities
  • Getting anti-vascular endothelial growth factor (anti-VEGF) eye injections or laser treatments if you have CNV and want to stop the development of new blood vessels
  • MMD is typically not treatable with laser vision surgery. 

If you have macular myopic degeneration, it’s crucial to schedule routine eye exams. It’s also advisable to inform your eye care provider as soon as you notice any changes in your vision.

Conclusion

A severe form of myopia, sometimes known as nearsightedness, called myopic macular degeneration worsens with time. 

Legal blindness and serious consequences including retinal detachment and (CNV) choroidal neovascularization are possible outcomes. 

Although there is no treatment for MMD, many people can improve their eyesight using glasses and contacts even if this doesn’t deal with the fundamental problem. Additionally, if they are detected early enough, several consequences of the disease can be managed. 

Regular eye exams are crucial, especially if you suffer from high-grade myopia or myopic macular degeneration. Maintaining frequent checkups might assist your doctor in identifying and treating any difficulties or eye health problems before they worsen.

If your family history has a lot of immediate family members who are nearsighted, you should try to limit your near work if possible.  If you spend a lot of time on your phone or computer it’s probably a good idea to wear some reading glasses to help keep your focusing system from working so hard. This has been shown to slow the progression of myopia.

FAQ’s

How fast does myopic macular degeneration progress?

In a recent study, over the course of six years, one in 80 myopic eyes got MMD, and one in six people who already had MMD saw MMD progress. Myopia severity and axial length of the eye were reliable indicators of the progression of MMD. The probability of MMD development was greater in eyes with severe MMD than in eyes with less severe MMD. These eyes also had worse visual acuity and a lower quality of life connected to their eyesight. 

Population-based research found that the rate of MMD advancement over five years varied from 15.1% to 35.3%,  and that it progressed at a rate of 77.4% of MMD-affected eyes over ten years. In contrast, clinic-based case series including Japanese patients revealed significant rates of MMD progression (54.7% to 74.3%) in patients with extremely severe myopia and a mean follow-up of at least 10 years. The majority of research on the MMD development pattern has only been done in populations with similar ethnic backgrounds.

Can you go blind from myopic degeneration?

Yes, the most extreme possible outcome from myopic degeneration is a complete retinal detachment. If left untreated for a long enough period, this could lead to complete blindness in that eye.  Other possible outcomes such as Choroidal neovascularization or lacquer cracks can lead to scarring in the macula and lead to legal blindness. Although this would not be complete blindness. 

What can be done for myopic degeneration?

As mentioned above, there is no cure for this condition. The treatments are for the resulting effects that the disease causes. Laser and anti-VEGF injections for CNV, Laser and scleral buckles for retinal detachments, etc.

Is macular degeneration the same as myopia?

Myopia is a term used to describe a condition that causes the eye to focus light in front of the retina. It is also known as near or short-sighted. Macular degeneration causes the small central part of the retina called the macula to atrophy or become scarred by other biomechanical processes.

What age does myopic macular degeneration start?

The frequency of MMD varies between 0.9% and 3.1% worldwide, while the visual impairment brought on by MMD varies between 0.1% and 1.4%. The prevalence of CNV in MMD patients ranges from 5.2% to 11.3% and affects both eyes in 15% of cases.  MMD can strike anyone at any age, however, it most frequently affects people between the ages of 30 and 40. In those under the age of 50, it’s frequently linked to CNV.

Is there a treatment for myopic macular degeneration?

There are treatments for the complications that may occur from the condition but not the condition itself.

Does myopia worsen with age?

Myopia often develops in early childhood. The disease usually slows its progression with age, but it can also get worse. As we get older we tend to do more activities that cause strain on the eye’s focusing system. These days we spend a lot of time on the computer, our phones and tablets.  These activities cause our eyes to have to focus which requires a muscle to have to be used to change the shape of the lens inside the eye. People who are myopic have the genes that when activated through a lot of near use and eye strain cause our eyes to adapt to the working conditions.  It causes a change in either the axial length of the eyeball or in the curvature of the cornea. This process makes it easier on the eyes so that they don’t have to focus as much.

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