TO STUDY POSTERIOR SEGMENT CHANGES IN HIGH MYOPIA PATIENTS ATTENDING TERTIARY CARE CENTRE
Main Article Content
Keywords
High myopia, Posterior segment, Axial length, Retinal degeneration, Optical coherence tomography
Abstract
Background: High myopia is a progressive refractive disorder associated with structural alterations in the posterior segment of the eye, often leading to vision-threatening complications. This study was conducted to assess the pattern and frequency of posterior segment changes and associated complications in patients with high myopia attending a tertiary care center.
Methods: A prospective observational study was conducted at the Department of Ophthalmology, Index Medical College Hospital and Research Centre, Indore, from July 2023 to June 2024. A total of 100 patients (200 eyes) with high myopia (refractive error > -6.00 D) were included. All patients underwent detailed ocular examination including BCVA assessment, refraction, slit-lamp evaluation, intraocular pressure measurement, and dilated fundus examination. OCT and B-scan ultrasonography were performed where necessary. Data were analyzed using SPSS version 26.0.
Results: The mean age was 25 ± 5 years, with 54% males. The mean refractive error was -9.0 ± 3.5 D; axial length >26 mm was seen in 68% of eyes. Posterior segment findings included tessellated fundus (49%), chorioretinal atrophy (22%), myopic maculopathy (18%), and posterior staphyloma (11%). Peripheral retinal changes such as lattice degeneration (42%) and WWOP (35%) were common. Vitreous changes, especially posterior vitreous detachment (36%), were frequent. Statistically significant associations were observed between increasing myopia severity and structural changes (p < 0.05). Complications included posterior subcapsular cataract (15%), glaucoma (10%), and retinal detachment (5%).
Conclusion: High myopia is strongly associated with progressive posterior segment degeneration and serious ocular complications. Early detection, systematic monitoring, and tailored interventions are essential to prevent irreversible vision loss.
References
2. Naidoo KS, Fricke TR, Frick KD, Jong M, Naduvilath TJ, Resnikoff S, Sankaridurg P. Potential lost productivity resulting from the global burden of myopia: systematic review, meta-analysis, and modeling. Ophthalmology. 2019 Mar 1;126(3):338-46.
3. Mehta N, Wen AN. Myopia: A global epidemic. Retin Today. 2019;2019:52-.
4. Flitcroft DI, He M, Jonas JB, Jong M, Naidoo K, Ohno-Matsui K, Rahi J, Resnikoff S, Vitale S, Yannuzzi L. IMI–defining and classifying myopia: a proposed set of standards for clinical and epidemiologic studies. Investigative ophthalmology & visual science. 2019 Feb 28;60(3):M20-30.
5. Wan C, Li H, Cao GF, Jiang Q, Yang WH. An artificial intelligent risk classification method of high myopia based on fundus images. Journal of Clinical Medicine. 2021 Sep 29;10(19):4488.
6. Ikuno Y. Overview of the complications of high myopia. Retina. 2017 Dec 1;37(12):2347-51.
7. Hayashi K, Ohno-Matsui K, Shimada N, Moriyama M, Kojima A, Hayashi W, Yasuzumi K, Nagaoka N, Saka N, Yoshida T, Tokoro T. Long-term pattern of progression of myopic maculopathy: a natural history study. Ophthalmology. 2010 Aug 1;117(8):1595-611.
8. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Progr Retinal Eye Res. 2012;31:622–60.
9. Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016 May 1;123(5):1036-42.
10. Karabulut S, Karti O, Zengin M, Karabulut M, Kusbeci T. Anterior and Posterior Segment Manifestations of Pathological Myopia: A Clinical Study from Turkish Aegean Region. Open Ophthalmol J. 2019;13:70–76.
11. Lyu T, Wang L, Zhou L, Qin J, Ma H, Shi M. Regimen study of high myopia-partial reduction orthokeratology. Eye Contact Lens. 2020;46:141–6.
12. Ayman G E, Joseph H T. Posterior Segment Manifestations of Pathological Myopia: A Review. JOJ Ophthal. 2019; 7(2): 555709.
13. Liu J, Lu Y, Huang D, Yang J, Fan C, Chen C, et al. The efficacy of defocus incorporated multiple segments lenses in slowing myopia progression: results from diverse clinical circumstances. Ophthalmology. 2023;130:542–50.
14. Polling JR, Tan E, Driessen S, Loudon SE, Wong HL, van der Schans A, et al. A 3-year follow-up study of atropine treatment for progressive myopia in Europeans. Eye. 2020;34:2020–8.
15. Lyu T, Wang L, Zhou L, Qin J, Ma H, Shi M. Regimen study of high myopia-partial reduction orthokeratology. Eye Contact Lens. 2020;46:141–6.
16. Jonas JB, Xu L, Wang YX. The Beijing Eye Study. Acta Ophthalmol. 2017;95:e61–e69.
17. Wu P-C, Huang H-M, Yu H-J, Fang P-C, Chen C-T. Epidemiology of Myopia. Asia Pacific Journal of Ophthalmology (Philadelphia, Pa.). 2019;8(5):386–393.
18. Fan DSP, Lam DSC, Chan CKM, Fan AH, Cheung EYY, Rao SK. Topical atropine in retarding myopic progression and axial length growth in children with moderate to severe myopia: a pilot study. Jpn J Ophthalmol. 2007;51:27–33.
19. Naik GT, Achar P, Dsouza NDA, Beary MSM. Fundus Changes in High Myopia in Relation to Axial Length of the Globe. J Pharm Bioallied Sci. 2022 Jul;14(Suppl 1):S649–S653.
20. Solu T, Bhavsar H, Patel I, Korat D, Mavani J. Evaluation of macula in high myopic fundus using optical coherence tomography. Indian J Clin Exp Ophthalmol. 2020;6(1):65–68.
21. Zhu MJ, Feng HY, He XG, Zou HD, Zhu JF. The control effect of orthokeratology on axial length elongation in Chinese participants with myopia. BMC Ophthalmol. 2014;14:1–9.
22. Dhakal R, Goud A, Narayanan R, et al. Patterns of posterior ocular complications in myopic eyes of Indian population. Sci Rep. 2018;8:13700
23. Shukla M, Anuja OP. White with pressure (WWP) and white without pressure (WWOP) lesions. Indian journal of ophthalmology. 1982 May 1;30(3):129.
24. Celorio J, Pruett RC. Prevalence of lattice degeneration and its relation to axial length in severe myopia. American journal of ophthalmology. 1991 Jan 1;111(1):20-3.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Mehul Singh Thakur
PG Resident (3rd Year), Department of Ophthalmology, Index Medical College Hospital & Research Centre, Indore (M.P)
Dr Sonalee Mittal
Professor & HOD, Department of Ophthalmology, Index Medical College Hospital & Research Centre, Indore (M.P)
Dr Mohammad Ali
PG Resident (2nd Year), Department of Ophthalmology, Index Medical College Hospital & Research Centre, Indore (M.P)