Myopia: Ocular and Systemic Disease
The study of high axial myopia in the setting of antecedent, concurrent, or subsequent ocular disorders, systemic diseases, hereditary syndromes, and systemic drug use may contribute to our understanding of the pathogenesis of myopia and even set the occa
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23
Quan V. Hoang, Jamie A. Leong, and Roberto Gallego-Pinazo
23.1
Introduction
The study of high axial myopia in the setting of antecedent, concurrent, or subsequent ocular disorders, systemic diseases, hereditary syndromes, and systemic drug use may contribute to our understanding of the pathogenesis of myopia and even set the occasion for the development of treatment. Although early recognition of mild myopic changes that commonly arise with certain ocular and systemic factors may limit the burden of vision loss with simple refractive correction, the recognition of high and pathologic axial myopia is important since there is a risk of permanent vision loss from vision-threatening sequelae. Therefore, the study of cases of high axial myopia, and specifically those cases in which there may be a causal relationship, is of particular interest. Additionally, recognition of the tendency of some Q.V. Hoang, MD, PhD (*) Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, 635 W. 165th Street, Suite 222A, New York, NY 10065, USA Vitreous Retina Macula Consultants of New York, New York, NY, USA LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA e-mail: [email protected] J.A. Leong, MS Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, 635 W. 165th Street, Suite 222A, New York, NY 10065, USA e-mail: [email protected] R. Gallego-Pinazo, MD, PhD Vitreous Retina Macula Consultants of New York, New York, NY, USA LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA Unit of Macular Diseases, Department of Ophthalmology, University and Polytechnic Hospital La Fe, Bulevar Sur, s/n, Valencia, VLC 46001, Spain e-mail: [email protected]
syndromes to be associated with high myopia heightens the clinical suspicion for detection of severe refractive errors in patients who may be preverbal or unable to effectively communicate. Clinical studies and basic scientific discoveries oftentimes mirror and motivate each other. In this chapter, we detail clinical observations and studies that have proven or may in the future prove themselves relevant to current thoughts on emmetropization and animal models of myopia discussed more thoroughly elsewhere in this book.
23.2
Myopia in Association with Ocular Diseases
Form-deprivation myopia and lens-induced myopia are two commonly employed techniques in establishing myopia animal models [1–6]. Additionally, studies have suggested that a change in the component scleral collagen in the eye wall or its turnover may contribute to pathologic eye elongation [7–11]. Not surprisingly, the majority of clinical reports and studies of ocular diseases that may have a causal relationship with high myopia tend to be related to visual deprivation or connective tissue disorders. The most revealing cases are those with unilateral axial high myopia [12] and twin studies [13]. There are also many other o
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