Prevention and Management of Myopia and Myopic Pathology

Invest Ophthalmol Vis Sci. 2019 Feb 1;60(2):488-499. doi: 10.1167/iovs.18-25221.

Abstract

Myopia is fast becoming a global public health burden with its increasing prevalence, particularly in developed countries. Globally, the prevalence of myopia and high myopia (HM) is 28.3% and 4.0%, respectively, and these numbers are estimated to increase to 49.8% for myopia and 9.8% for HM by 2050 (myopia defined as -0.50 diopter [D] or less, and HM defined as -5.00 D or less). The burden of myopia is tremendous, as adults with HM are more likely to develop pathologic myopia (PM) changes that can lead to blindness. Accordingly, preventive measures are necessary for each step of myopia progression toward vision loss. Approaches to prevent myopia-related blindness should therefore attempt to prevent or delay the onset of myopia among children by increased outdoor time; retard progression from low/mild myopia to HM, through optical (e.g., defocus incorporated soft contact lens, orthokeratology, and progressive-additional lenses) and pharmacological (e.g., low dose of atropine) interventions; and/or retard progression from HM to PM through medical/surgical treatments (e.g., anti-VEGF therapies, macula buckling, and scleral crosslinking). Recent clinical trials aiming for retarding myopia progression have shown encouraging results. In this article, we highlight recent findings on preventive and early interventional measures to retard myopia, and current and novel treatments for PM.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atropine / administration & dosage*
  • Blindness / prevention & control
  • Contact Lenses, Hydrophilic
  • Cross-Linking Reagents / therapeutic use*
  • Disease Progression
  • Humans
  • Muscarinic Antagonists / administration & dosage
  • Myopia / pathology
  • Myopia / prevention & control*
  • Myopia / therapy*
  • Myopia, Degenerative / pathology
  • Myopia, Degenerative / prevention & control
  • Myopia, Degenerative / therapy
  • Ophthalmologic Surgical Procedures*
  • Orthokeratologic Procedures*

Substances

  • Cross-Linking Reagents
  • Muscarinic Antagonists
  • Atropine