Review highlights burden of high myopia: From early cataracts to anxiety

High myopia leads to severe ocular complications beyond simple refractive errors, including cataracts, retinal issues, and glaucoma, according to a new review.

High myopia was also found to be associated with the newly recognized extra-ocular complication of anxiety.

The complications associated with high myopia extend beyond simple refractive errors, according to the review. Patients face a range of serious eye conditions including lens pathologies, atrophic and tractional maculopathy, choroidal neovascularization, peripheral retinal degenerations, retinal detachment, and glaucoma. These individuals are also at higher risk of elevated intraocular pressure.

The review stated that high myopia can lead to early onset of cataracts, overgrowth of the lens, weakened zonules, and postoperative capsular contraction syndrome, potentially driven by inflammatory processes. However, there are 2 newly identified protective factors for central vision in highly myopic patients: dome-shaped macula and cilioretinal arteries.

In addition to eye complications, patients with high myopia are more susceptible to open-angle glaucoma and IOP spikes following intraocular surgery. Detecting glaucoma in these patients is challenging due to morphological changes in the optic nerve, necessitating comprehensive examinations and close follow-ups. Interestingly, while a thinner trabecular meshwork increases glaucoma risk, lamina cribrosa defects might provide a fluid outlet, potentially reducing pressure.

A notable discovery is the emergence of anxiety as the first recognized extra-ocular complication in high myopia, suggesting an inflammatory link between visual stimulus, blood, and brain.

Reference
Du Y, Meng J, He W, et al. Complications of high myopia: An update from clinical manifestations to underlying mechanisms. Adv Ophthalmol Pract Res. 2024;4(3):156-163. doi: 10.1016/j.aopr.2024.06.003. PMID: 39036706; PMCID: PMC11260019.