High Myopia

Description:

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High myopia involves a wider growth of the eye than average, its increased length resulting in the tensioning and weakening of various elements. It creates refractive visual problems, which are corrected by corrective lenses (glasses or contact lenses). But high myopia can also trigger other specific pathologies.

Symptoms:

Myopic staphyloma
Patients suffering from high myopia might experience blind spots in their visual field, called scotomas. They correspond to some atrophic areas at the back of the retina created by the lengthening of the eye.

Choroidal newvessels
This lengthening can also create breaks in a subretinal membrane (the Bruch membrane), opening a communication with the choroidal vascular network. In some cases fragile and anomalous blood vessels (called newvessels) appear under the retina, resulting in the accumulation of blood and fluids. These vessels are different from the AMD ones. In this case the clinical symptoms are a fall in central visual acuity, a distortion of images and the perception of dark patches in the visual field. The diagnosis rests on a fundus examination associated to OCT examination and fluorescein angiography. Treatment requires intravitreal injections of anti-VEGF molecules. In most cases, a couple of injections are enough to heal the blood vessels so that the wound doesn’t recur chronically.

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Epiretinal membranes and retinoschisis
The appearance of membranes at the surface of the retina is more frequent among patients suffering from high myopia than in the rest of the population. These membranes are well tolerated and do not require a surgical removal so long as visual acuity remains stable. Patients suffering from high myopia might develop a specific condition of central retina called retinoschisis. This anomaly corresponds to a splitting of the distended retinal layers. It is diagnosed by an OCT retinal examination. It doesn’t require surgery unless visual acuity is strongly decreasing.

Retinal detachment
Retinal detachment is more frequent among patients suffering from high myopia than in the rest of the population because of the anatomical changes due to the lengthened eye morphology and to the fragility of the peripheral retina. It is necessary to have a fundus examination every year or every two years. These regular checks will make it possible to detect and preventively treat holes, breaks or significant weak points which might cause a retinal detachment (through laser photocoagulation techniques). In case of a formed retinal detachment, the treatment is surgical.

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