Pathologic myopia

Pathologic myopia is a major cause of legal blindness and low vision worldwide, especially in East Asian countries. Axial elongation in myopic eyes usually occurs in the equatorial region of the eye, or a posterior staphyloma creates a deformity in the eye’s posterior pole. The term pathologic myopia refers to myopic eyes that have myopic chorioretinal atrophy equal to or more serious than diffuse choroidal atrophy, or it classifies myopic eyes that have posterior staphyloma. A formation of posterior staphyloma is a hallmark of pathologic myopia, and it almost exclusively occurs in pathologic myopia (besides some uncommon diseases). In the area of staphylomas, the neural retina and the optic nerve are mechanically damaged, causing various kinds of vision-threatening complications. These include myopic maculopathy (diffuse atrophy, patchy atrophy, lacquer cracks, choroidal neovascularization); myopic traction maculopathy; and glaucoma/myopic optic neuropathy. The chapter describes advances in imaging (e.g., optical coherence tomography (OCT) and OCT angiography) and treatment (e.g., anti-VEGF therapies and vitreoretinal surgeries) relative to pathologic myopia.