Breaking News from the ASCRS Meeting in Washington DC

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Eyewire reports on new products and breaking news live from the American Society of Cataract and Refractive Surgery meeting in Washington DC.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Beyond the Diopter: Myopia’s Mark on the Retina and Choroid

Watch out for posterior segment complications in this patient population.

Vyoma Shinde, OD

Modern Optometry

Myopia affects 30% of the global population and is predicted to reach nearly 50% by 2050.1,2 As the severity of myopia increases, certain mechanical and vascular stresses are placed on the posterior segment, which can intensify or contribute to various structural complications. While it may seem convenient and natural to use spherical equivalent as the standard clinical metric for judging myopia severity, it can also be helpful to evaluate axial length, which offers a more direct understanding of structural risk. After all, just a 1-mm increase in axial length increases myopia by 3.00 D.3 This article reviews the changes that occur in the retina and choroid with varying levels of myopia and offers insights on risk stratification and early intervention. LOW MYOPIA In low myopia (-3.00 D or better, 24.5 mm to 25 mm), fundus appearance is typically similar to an emmetrope or low hyperope, but subtle changes can be observed. Early signs include mild tessellation (Figure 1), which reflects thinning of the choroid and increased visibility of the choroidal vasculature beneath the retina.4 Occasionally, benign peripheral retinal findings or lattice may be seen. Foveal contour and retinal thickness are typically intact and within normal limits. Choroidal thickness remains relatively well-preserved at 250 µm to 300 µm.5 Clinically, these patients are at a low risk of serious complications; however, documenting axial length and obtaining baseline imaging is recommended to track progression and enable future comparisons. Figure 1. Fundus photography of the right (A, -2.00 D) and left (B, -0.50 D) eye of a patient with low myopia shows mild tessellation in the right eye and, to a lesser extent, the left eye. MODERATE MYOPIA Moderate myopia (-3.25 D to -6.00 D, 25 mm to 26.5 mm) typically presents with changes in the structure and vasculature of the retina and choroid compared with low myopia.

Biogen Enters GA Treatment Market After Major Acquisition

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Pharma giant Biogen announces its intention to acquire Apellis in a multi-billion dollar deal; a recently approved first-of-its-kind presbyopia drop is commercially launched; and Kodiak Sciences releases phase 3 data for its diabetic retinopathy drug candidate. Learn more about your ad choices. Visit megaphone.fm/adchoices