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Peripheral Retinal Abnormalities

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Pathologic Myopia

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Abstract

The major peripheral chorioretinal changes associated with pathologic myopia are lattice degeneration, white-without-pressure, pigmentary degeneration, paving stone degeneration, retinal holes, retinal tears, and retinal detachment. Each of these entities has a distinct morphology and prevalence varying with age and axial length. They are all prone to progression, although the number and extent of the lattice lesions tend to not progress after the teens. The dynamic interaction between the vitreous and the retina plays an important role in the development, appearance, and progression of these peripheral retinal changes. The combination of abnormal vitreoretinal adhesions, traction upon them by posterior vitreous detachment, and liquefied vitreous gel that can access into retinal breaks is necessary to produce a rhegmatogenous retinal detachment. High myopes have an increased liquid component of the vitreous gel, associated with reduced viscosity and stability and an increased frequency of abnormal vitreoretinal adhesions, whether they are visible, such as lattice degeneration, or invisible leading to retinal breaks. They also have an increased frequency of posterior vitreous detachment at a younger age compared to emmetropic patients. Therefore, high myopes have an increased frequency of rhegmatogenous retinal detachments at a younger age.

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Authors and Affiliations

  1. Vitreoretinal Private Practice, Macula Consultants of New York, 460 Park Avenue, 5th Floor, New York, NY, 10022, USA

    Sarah Mrejen MD & Michael Engelbert MD, PhD

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  1. Sarah Mrejen MD
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  2. Michael Engelbert MD, PhD
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Correspondence to Sarah Mrejen MD .

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Editors and Affiliations

  1. Vitreous, Retina, Macula Consultants of New York, New York, New York, USA

    Richard F. Spaide

  2. Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan

    Kyoko Ohno-Matsui

  3. Department of Clinical Ophthalmology, Columbia University School of Medicine, LuEsther T. Mertz Retinal Research Center, New York, New York, USA

    Lawrence A. Yannuzzi

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Mrejen, S., Engelbert, M. (2014). Peripheral Retinal Abnormalities. In: Spaide, R., Ohno-Matsui, K., Yannuzzi, L. (eds) Pathologic Myopia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8338-0_17

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