The Eye Treatment Centre, Whipps Cross Hospital, Whipps Cross, London E11 1NR, UK.
Graefes Arch Clin Exp Ophthalmol. 2012 Jan;250(1):3-13. doi: 10.1007/s00417-011-1889-0. Epub 2011 Dec 13.
Pathological myopia is a frequent cause of secondary visual disturbance in young individuals worldwide. Myopic maculopathy describes a spectrum of clinical changes that comprise the main cause of visual loss among highly myopic individuals. Our aim is to describe current trends in the medical and surgical management of maculopathy secondary to pathological myopia.
The epidemiology, natural history, medical and surgical treatment modalities for choroidal neovascular membrane (CNV) and vitreomacular disorders secondary to pathological myopia (PM) are reviewed and evaluated.
The medical and surgical treatment modalities in the management of myopic maculopathy have evolved over time. Laser photocoagulation, photodynamic therapy with verteporfin and other medical treatments have been superseded by the use of anti-vascular endothelial growth factor in the management of CNV secondary to PM. Surgical treatments are beneficial in the treatment of vitreomacular interface disorders such as macular hole retinal detachment and macular traction; however, primary success rates remain lower than those for non-myopic individuals.
This updated clinical perspective demonstrates that CNV and vitreomacular disorders in pathological myopia are treatable conditions. There are numerous medical and surgical interventions that have significantly improved the outcome of myopic maculopathy and several others currently under investigation. Nonetheless, as technology advances, further well-designed studies are necessary to establish a uniform evidence-based approach for classification and treatment.
病理性近视是全球年轻人继发性视觉障碍的常见原因。近视性黄斑病变描述了一系列临床变化，是高度近视患者视力丧失的主要原因。我们旨在描述病理性近视继发黄斑病变的医学和手术治疗的当前趋势。
回顾和评估脉络膜新生血管膜（CNV）和病理性近视（PM）继发玻璃体黄斑病变的流行病学、自然史、医学和手术治疗方法。
随着时间的推移，病理性近视性黄斑病变的医学和手术治疗方法也在不断发展。激光光凝、维替泊芬光动力疗法和其他药物治疗已被抗血管内皮生长因子治疗 PM 继发的 CNV 所取代。手术治疗对视神经黄斑界面病变如黄斑裂孔视网膜脱离和黄斑牵引有益；然而，原发性成功率仍低于非近视患者。
本临床观点更新表明，病理性近视中的 CNV 和玻璃体黄斑病变是可治疗的疾病。有许多医学和手术干预措施显著改善了近视性黄斑病变的预后，还有一些正在研究中。然而，随着技术的进步，需要进一步进行精心设计的研究，以建立一个统一的基于证据的分类和治疗方法。
