Myopic maculopathy: Current status and proposal for a new classification and grading system (ATN)

作者：Jorge Ruiz‐Medrano, Javier A. Montero, Ignacio Flores‐Moreno, Luís Arias, Alfredo García‐Layana, José M. Ruiz‐Moreno · 发表于：Progress in Retinal and Eye Research · 年份：2018 · DOI：10.1016/j.preteyeres.2018.10.005 · 被引用次数：464 · 研究领域：Retinal Diseases and Treatments、Retinal Imaging and Analysis、Glaucoma and retinal disorders

Myopia is a highly frequent ocular disorder worldwide and pathologic myopia is the 4th most common cause of irreversible blindness in developed countries. Pathologic myopia is especially common in East Asian countries. Ocular alterations associated with pathologic myopia, especially those involving the macular area-defined as myopic maculopathy-are the leading causes of vision loss in patients with pathologic myopia. High myopia is defined as the presence of a highly negative refractive error (>-6 to -8 diopters) in the context of eye elongation (26-26.5 mm). Although the terms high myopia and pathologic myopia are often used interchangeably, they do not refer to the same eye disease. The two key factors driving the development of pathologic myopia are: 1) elongation of the axial length and 2) posterior staphyloma. The presence of posterior staphyloma, which is the most common finding in patients with pathologic myopia, is the key differentiating factor between high and pathologic myopia. The occurrence of staphyloma will, in most cases, eventually lead to other conditions such as atrophic, traction, or neovascular maculopathy. Posterior staphyloma is for instance, responsible for the differences between a myopic macular hole (MH)-with and without retinal detachment-and idiopathic MH. Posterior staphyloma typically induces retinal layer splitting, leading to foveoschisis in myopic MH, an important differentiating factor between myopic and emmetropic MH. Myopic maculopathy is ...