Myopic Maculopathy: A Long Term Effect of High Myopia

What is myopic maculopathy?

Myopic maculopathy (also called pathologic myopia or myopic macular degeneration) is damage to the macula caused by the eye’s elongation. It ranges from subtle changes to severe scarring and atrophy.

Common features include:

• Thinning and atrophy of the retina and choroid

• “Lacquer cracks” (tiny breaks) in a layer under the retina

• Posterior staphyloma (outpouching) that distorts the eye’s shape

• Myopic choroidal neovascularisation (new, fragile blood vessels under the macula)

How it develops

As the eye elongates, the tissues at the back are under constant mechanical stress. Thinner tissues are more vulnerable to breaks and abnormal healing. In some cases, the body grows new blood vessels to compensate, but these are leaky and can scar, damaging central vision.

What happens if left untreated

• Slow, progressive vision decline from macular atrophy

• Sudden central blur or distortion if new blood vessels form and leak

• Potential irreversible loss of reading, driving and face‑recognition vision

• Early changes can be subtle. Regular monitoring with retinal photographs and OCT scans helps detect problems before major vision loss occurs.

How myopic maculopathy is treated

• Anti‑VEGF injections: If abnormal blood vessels develop (myopic CNV), anti‑VEGF medicine injected into the eye can stop leakage and reduce scarring. Early treatment usually gives the best results.

• Observation and protection: Atrophic changes often cannot be reversed, but careful monitoring, good lighting, glare control and magnification can help.

• Low‑vision support: Devices and training can maximise remaining vision if central vision is affected.

Why preventative myopia management matters

The risk and severity of myopic maculopathy rise with each step of eye elongation. Slowing myopia progression in childhood can lower the lifetime chance of macular damage. Evidence‑based options—specialised spectacle or contact lenses, orthokeratology, and low‑dose atropine—combined with more time outdoors and regular breaks from near tasks, can significantly slow progression. Ask your eye care professional to measure axial length, track changes, and tailor a plan to protect long‑term macular health.

Prompt care for sudden distortion or central blur is essential—especially in people with high myopia.