Increase in myopia will lead to rise in retinal conditions
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ORLANDO, Fla. – The growing incidence of myopia will be associated with an increased risk of retinal conditions, and patients should be educated on the signs and symptoms, Judy E. Kim, MD, said.
Kim, professor of ophthalmology, director of teleophthalmology and research, and vitreoretinal diseases and surgery specialist at Medical College of Wisconsin, spoke here at the American Academy of Optometry meeting during a joint American Academy of Ophthalmology-AAO symposium on myopia.
“By 2050, half of the world will have myopia,” Kim said, “and with this increase in incidence we can expect an increase in comorbidity. It increases the risk of retinal tears and detachments, but also other conditions.”
Pathologic myopia is considered to be a refractive error greater than 6 D and an axial length greater than 26 mm, she said.
Macular degenerative changes are common in those with high myopia; high myopia increases the risk of retinal detachment; and secondary choroidal neovascularization is common, Kim said.
In addition, however, eyes with high myopia are at an increased risk for developing glaucoma, “and they have a thinned cornea, so it’s difficult to assess IOP,” Kim said. “Myopic eyes have physiological and enlarged cupping and tilted discs. It is difficult to interpret visual fields and OCT.
“These eyes have an increased risk of intraoperative as well as postoperative complications,” she added.
“I expect more surgeries to improve outcomes for these patients, but we must educate patients on the signs and symptoms of tears and retinal detachment,” Kim said.
She said that one of the challenges for surgeons is that instruments for vitrectomy machines are made for emmetropic eyes, “and they’re not long enough, so sometimes we really struggle to get to the macula.”
Kim said that the use of OCT can be helpful in these longer eyes to find issues that may be difficult to visualize on clinical exam.
“If a patient has visual symptoms and a decrease in vision that’s not accountable otherwise during the exam, use OCT,” she said, recommending that clinicians see these patients once a year, particularly if their vision is changing. – by Nancy Hemphill, ELS, FAAO
Reference:
Walline J, et al. Addressing the global myopia burden. Presented at: American Academy of Optometry meeting; Orlando, Fla.; October 22-27, 2019.
Disclosure: Kim reports she is advisory board member for Adverum, Alimera Sciences, Allergan, Eyepoint, Gemini, Genentech, Graybug, Kodiak, Notal Vision and Novartis.
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