Abstract
Purpose :
To investigate the axial length changes in older patients presenting with myopic maculopathy secondary to degenerative myopia.
Methods :
Five eyes of three consecutive patients (ages 61-88) with myopic maculopathy secondary to degenerative myopia were studied. All eyes were aphakic or pseudophakic following cataract surgery performed 9-18 years prior. The current axial lengths were compared with the axial lengths measured at the time of cataract surgery.
Results :
The follow-up time was between 9-18 (13+/-3.94) years. The initial axial length was between 27.94-30.84 (29.15+/-1.08) mm. The final axial length was between 29.35-32.00 (30.47+/-1.11) mm. The axial length increased by 0.10-2.04 (1.32+/-0.75) mm, which corresponds to an average 3.96 diopter myopic shift, during the average follow-up of 13 years. Initial maculopathy findings were pigment stippling of posterior macular staphyloma, diffuse hypopigmentation, and patchy atrophic scars not involving the fovea. None of these affected the best corrected visual acuity. Additional maculopathy in the final visit included the formation of choroidal neovascular membrane (CNVM), epiretinal membrane (ERM) formation, vitreomacular traction (VMT), and maculoschisis.
Conclusions :
Axial length may increase in older patients with degenerative myopia presenting with myopic maculopathy. Determining cause and effect relationship requires further study. The patients’ initial axial measurements were made at the time of cataract surgery. They then experienced an undesirable myopic shift averaging 3.96 diopters over a mean of 13 years. Patients with myopic degeneration undergoing cataract surgery should be informed of the potential for increase in their ocular axial length over the following decade and longer; moreover, they may need further attention due to potential development of myopic shift and progression of myopic maculopathy. Some of those maculopathies (such as CNVM formation) may require immediate intervention. The elongation trend seen in degenerative myopia may have been occurring even prior to cataract surgery, but lack of long-term monitoring measurements before surgery makes it difficult to determine.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.