Posterior Segment Manifestations of Pathological Myopia: A Review

Abstract

Pathological myopia is a major cause of blindness worldwide that is becoming increasingly more prevalent in many countries of the world including Egypt [1,2]. Its exact cause is unknown; however, multiple genetic and environmental factors are thought to play a role in its complex pathogenesis [3]. The hallmark of pathological myopia is excessive and progressive axial length elongation which leads to degenerative changes in the sclera, choroid, and retinal pigment epithelium and compromises visual function [4,5]. Clinically, these changes include tessellated fundus, lacquer cracks, atrophy of the retinal pigment epithelium and choroid, choroidal neovascular membrane, posterior staphyloma, Fuchs’ spot, macular hole, foveoschisis, retinal breaks and detachments, and peripheral retinal lesions [6]. The effect of these manifestations on the visual performance of patients with pathological myopia can be substantial which emphasizes the value of the correct diagnosis and management of these complications. In this article, we review the clinical and morphological characteristics of the various posterior segment manifestations that can occur in pathological myopia as well as the value of multimodal imaging in the diagnosis and management of these manifestations.