Complications of high myopia:An update from clinical manifestations to underlying mechanisms  

作　　者：Yu Du Jiaqi Meng Wenwen He Jiao Qi Yi Lu Xiangjia Zhu 

机构地区：[1]Eye Institute and Department of Ophthalmology,Eye&ENT Hospital,Fudan University,Shanghai,China [2]NHC Key Laboratory of Myopia and Related Eye Diseases,Key Laboratory of Myopia and Related Eye Diseases,Chinese Academy of Medical Sciences,Shanghai,China [3]Shanghai Key Laboratory of Visual Impairment and Restoration,Shanghai,China [4]State Key Laboratory of Medical Neurobiology,Fudan University,Shanghai,China

出　　处：《Advances in Ophthalmology Practice and Research》2024年第3期156-163,共8页眼科实践与研究新进展（英文）

基　　金：supported by research grants from the National Natural Science Foundation of China(82122017,82271069,81870642,82371040,81970780,82201161,81470613 and 81670835);Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission(23Y11909800 and 21S31904900);Outstanding Youth Medical Talents of Shanghai“Rising Stars of Medical Talents”Youth Development Program,Clinical Research Plan of Shanghai Shenkang Hospital Development Center(SHDC12020111);Shanghai Municipal Key Clinical Specialty Program(shslczdzk01901).

摘　　要：Background:High myopia is one of the major causes of visual impairment and has an ever-increasing prevalence,especially in East Asia.It is characterized by excessive axial elongation,leading to various blinding complications that extend beyond mere refractive errors and persist immovably after refractive surgery,presenting substantial public health challenge.Main text:High myopia-related complications include lens pathologies,atrophic and tractional maculopathy,choroidal neovascularization,peripheral retinal degenerations and retinal detachment,and glaucoma and heightened susceptibility to intraocular pressure(IOP)elevation.Pathological lens changes characteristic of high myopia include early cataractogenesis,overgrowth of lens,weakened zonules,and postoperative capsular contraction syndrome,possibly driven by inflammatory pathogenesis,etc.Dome-shaped macula and cilioretinal arteries are two newly identified protective factors for central vision of highly myopic patients.These patients also face risks of open-angle glaucoma and IOP spike following intraocular surgery.Morphologic alternations of optic nerve in high myopia can complicate early glaucoma detection,necessitating comprehensive examinations and close follow-up.Anatomically,thinner trabecular meshwork increases this risk;conversely lamina cribrosa defects may offer a fluid outlet,potentially mitigating the pressure.Notably,anxiety has emerged as the first recognized extra-ocular complication in high myopia,with an underlying inflammatory pathogenesis that connects visual stimulus,blood and brain.Conclusions:High myopia induces multiple ocular and potential mental health complications,underscoring the need to develop more effective strategies to improve both physical and emotional well-being of these patients,among which anti-inflammation might possibly represent a promising new target.

关 键 词：High myopia CATARACT Myopic maculopathy Open-angle glaucoma ANXIETY 

分 类 号：R778.11[医药卫生—眼科]