In recent years, the incidence of high myopia has increased year by year, and the population of high myopia will account for 9 percent of the total population8%。High myopia can lead to a range of complications that impair vision and greatly increase the risk of macular degeneration. Vision impairment caused by macular degeneration of high myopia has been the first cause of blindness and disability in central Shanghai**.
High myopia can be simply defined as myopia with a myopia degree of more than 600 degrees, while high myopic macular degeneration refers to pathological changes in the macular area of the fundus on the basis of high myopia. The macular area is the most sensitive part of the retina and corresponds to the best vision, so lesions in the macular area often affect central vision. It is often manifested as blurred vision in the center, distorted vision, scotomas and so on. High myopic macular degeneration can be divided into three main categories: myopic atrophic macular degeneration, myopic traction macular degeneration, and myopic neovascular macular degeneration.
In addition to basic visual acuity and fundus examinations, patients need to complete a number of ancillary tests to understand the classification of the disease and help determine the best options. For example, optical coherence tomography (OCT) and blood flow OCT (OCTA), fundus fluorescein contrast and indocyanine angiography.
Macular degeneration of high myopia can be prevented and treated. From the beginning of children and adolescents, we should pay attention to the prevention and control of myopia, actively prevent and control the occurrence and development of myopia, cultivate good eye habits, eat a balanced diet, and ensure sufficient outdoor activity time to slow down the development of high myopia.
For myopic neovascular macular degeneration, the current effective regimen is to inject anti-VEGF drugs into the eye to improve visual function by inhibiting neovascularization and reducing leakage. For myopic traction macular degeneration, close follow-up observation is required, and minimally invasive vitreous surgery** is required in time when visual acuity loss is significantly caused by traction to prevent vision loss caused by macular hole and hiatious retinal detachment. There are currently limited approaches to atrophic macular degeneration with high myopia, and studies have shown that limiting the scope and progression of posterior scleral staphyloma and human retinal pigment epithelial cell transplantation can slow the progression of atrophy.
Macular degeneration of high myopia is a potential blinding eye disease that leads to visual impairment and irreversible damage to visual function. The incidence of it increases with age and myopia. It is recommended that people with myopia greater than 600 degrees receive a comprehensive eye examination at least once a year, and if there is a problem, it can be detected early and early to avoid vision loss. The Department of Ophthalmology of Shibei Hospital has introduced Shanghai's first international advanced swept OCT and OCTA, which can provide ultra-wide and ultra-high-resolution three-dimensional fundus images, which can detect macular degeneration with high myopia earlier, and can choose a more appropriate period for surgical intervention
Chen Jili (Director of the Department of Ophthalmology, Shibei Hospital, Jing'an District, Shanghai, Shanghai Medical Craftsman Award).