Li Yong, Foo Li-Lian, Wong Chee Wai, Li Jonathan, Hoang Quan V, Schmetterer Leopold, Ting Daniel S W, Ang Marcus
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Ophthalmology and Visual Sciences Department, Duke-NUS Medical School, Singapore.
Br J Ophthalmol. 2023 May;107(5):600-606. doi: 10.1136/bjophthalmol-2021-320926. Epub 2022 Mar 14.
Pathologic myopia is a severe form of myopia that can lead to permanent visual impairment. The recent global increase in the prevalence of myopia has been projected to lead to a higher incidence of pathologic myopia in the future. Thus, imaging myopic eyes to detect early pathological changes, or predict myopia progression to allow for early intervention, has become a key priority. Recent advances in optical coherence tomography (OCT) have contributed to the new grading system for myopic maculopathy and myopic traction maculopathy, which may improve phenotyping and thus, clinical management. Widefield fundus and OCT imaging has improved the detection of posterior staphyloma. Non-invasive OCT angiography has enabled depth-resolved imaging for myopic choroidal neovascularisation. Artificial intelligence (AI) has shown great performance in detecting pathologic myopia and the identification of myopia-associated complications. These advances in imaging with adjunctive AI analysis may lead to improvements in monitoring disease progression or guiding treatments. In this review, we provide an update on the classification of pathologic myopia, how imaging has improved clinical evaluation and management of myopia-associated complications, and the recent development of AI algorithms to aid the detection and classification of pathologic myopia.
病理性近视是一种严重的近视形式，可导致永久性视力损害。最近全球近视患病率上升，预计未来病理性近视的发病率也会更高。因此，对近视眼睛进行成像以检测早期病理变化，或预测近视进展以便进行早期干预，已成为关键优先事项。光学相干断层扫描（OCT）的最新进展推动了近视性黄斑病变和近视性牵引性黄斑病变新分级系统的建立，这可能会改善表型分析，进而改善临床管理。广角眼底和OCT成像提高了后巩膜葡萄肿的检测率。非侵入性OCT血管造影能够对近视性脉络膜新生血管进行深度分辨成像。人工智能（AI）在检测病理性近视和识别近视相关并发症方面表现出色。这些成像技术与辅助AI分析的进展可能会改善疾病进展监测或指导治疗。在本综述中，我们提供了病理性近视分类的最新情况、成像如何改善近视相关并发症的临床评估和管理，以及用于辅助病理性近视检测和分类的AI算法的最新进展。
