Reflections on the diagnosis and treatment of high myopia_Chinese Journal of Ocular Fundus Diseases

Authors：

 Jin Zibing , He Hailong , Ma Ya , Xu Tianze , Liu Yixin

Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, National Engineering Research Center for Ophthalmology, Beijing 100730, China;

Corresponding author：

Jin Zibing, Email: jinzb502@ccmu.edu.cn

Keywords：

Myopia, degenerative; High myopia; Editorial; Artificial intelligence

DOI：

10.3760/cma.j.cn511434-20230704-00296

Video：

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High myopia has become a global public health issue, posing a significant threat to visual health. There are still some problems in the process of diagnosis and treatment, including the definition of high myopia and pathological myopia, opportunities and challenges of artificial intelligence in the diagnosis and treatment system, domestic and international collaboration in the field of high myopia, the application of genetic screening in children with myopia and high myopia patients, and the exploration of new treatment methods for high myopia. Nowadays, myopia and high myopia show the characteristics of early onset age and sharp rise in prevalence, and gradually become the main cause of low vision and irreversible blindness in young and middle-aged people. Therefore, it is of great significance to accurately define high myopia and pathological myopia, combine artificial intelligence and other methods for screening and prevention, promote cooperation in different fields, strengthen gene screening for early-onset myopia and adopt new and effective ways to treat it.

Citation： Jin Zibing, He Hailong, Ma Ya, Xu Tianze, Liu Yixin. Reflections on the diagnosis and treatment of high myopia. Chinese Journal of Ocular Fundus Diseases, 2023, 39(8): 619-625. doi: 10.3760/cma.j.cn511434-20230704-00296 Copy

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1. Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050[J]. Ophthalmology, 2016, 123(5): 1036-1042. DOI: 10.1016/j.ophtha.2016.01.006.
2. Flitcroft DI, He M, Jonas JB, et al. IMI-defining and classifying myopia: a proposed set of standards for clinical and epidemiologic studies[J]. Invest Ophthalmol Vis Sci, 2019, 60(3): 20-30. DOI: 10.1167/iovs.18-25957.
3. Joint World Health Organization-Brien Holden Vision Institute Global Scientific Meeting on Myopia. The impact of myopia and high myopia[EB/OL]. (2013-03-16)[2023-07-04]. https://www.researchgate.net/publication/318216691.
4. Cumberland PM, Bountziouka V, Rahi JS. Impact of varying the definition of myopia on estimates of prevalence and associations with risk factors: time for an approach that serves research, practice and policy[J]. Br J Ophthalmol, 2018, 102(10): 1407-1412. DOI: 10.1136/bjophthalmol-2017-311557.
5. Ohno-Matsui K, Wu PC, Yamashiro K, et al. IMI pathologic myopia[J]. Invest Ophthalmol Vis Sci, 2021, 62(5): 5. DOI: 10.1167/iovs.62.5.5.
6. Ohno-Matsui K, Lai TY, Lai CC, et al. Updates of pathologic myopia[J]. Prog Retin Eye Res, 2016, 52: 156-187. DOI: 10.1016/j.preteyeres.2015.12.001.
7. Ohno-Matsui K, Kawasaki R, Jonas JB, et al. International photographic classification and grading system for myopic maculopathy[J]. Am J Ophthalmol, 2015, 159(5): 877-883. DOI: 10.1016/j.ajo.2015.01.022.
8. Moriyama M, Ohno-Matsui K, Hayashi K, et al. Topographic analyses of shape of eyes with pathologic myopia by high-resolution three-dimensional magnetic resonance imaging[J]. Ophthalmology, 2011, 118(8): 1626-1637. DOI: 10.1016/j.ophtha.2011.01.018.
9. Wang NK, Wu YM, Wang JP, et al. Clinical characteristics of posterior staphylomas in myopic eyes with axial length shorter than 26.5 millimeters[J]. Am J Ophthalmol, 2016, 162: 180-190. DOI: 10.1016/j.ajo.2015.11.016.
10. Zhang C, Zhao J, Zhu Z, et al. Applications of artificial intelligence in myopia: current and future directions[J/OL]. Front Med (Lausanne), 2022, 9: 840498[2022-03-11]. https://pubmed.ncbi.nlm.nih.gov/35360739/. DOI: 10.3389/fmed.2022.840498.
11. Du R, Ohno-Matsui K. Novel uses and challenges of artificial intelligence in diagnosing and managing eyes with high myopia and pathologic myopia[J/OL]. Diagnostics (Basel), 2022, 12(5): 1210[2022-05-12]. https://pubmed.ncbi.nlm.nih.gov/35626365/. DOI: 10.3390/diagnostics12051210.
12. Shao L, Zhang QL, Long TF, et al. Quantitative assessment of fundus tessellated density and associated factors in fundus images using artificial intelligence[J]. Transl Vis Sci Technol, 2021, 10(9): 23. DOI: 10.1167/tvst.10.9.23.
13. Song AP, Wu XY, Wang JR, et al. Measurement of retinal thickness in macular region of high myopic eyes using spectral domain OCT[J]. Int J Ophthalmol, 2014, 7(1): 122-127. DOI: 10.3980/j.issn.2222-3959.2014.01.23.
14. Su L, Ji YS, Tong N, et al. Quantitative assessment of the retinal microvasculature and choriocapillaris in myopic patients using swept-source optical coherence tomography angiography[J]. Graefe's Arch Clin Exp Ophthalmol, 2020, 258(6): 1173-1180. DOI: 10.1007/s00417-020-04639-2.
15. 陈卓, 高建华, 刘康. 国际近视研究院白皮书[J]. 中华实验眼科杂志, 2019, 37(12): 1004-1023. DOI: 10.3760/cma.j.issn.2095-0160.2019.12.014.Chen Z, Gao JH, Liu K. International myopia institute white papers[J]. Chin J Exp Ophthalmol, 2019, 37(12): 1004-1023. DOI: 10.3760/cma.j.issn.2095-0160.2019.12.014.
16. 国家卫生健康委员会. 近视防治指南[J]. 中国眼镜科技杂志, 2018, 7(13): 98-102.National Health Commission. Myopia prevention guide[J]. China Glasses Science-Technology, 2018, 7(13): 98-102.
17. 近视管理白皮书(2019)国家卫生健康委员会. 近视防治指南[EB/OL]. (2020-11-05)[2023-07-04]. http://www.nhc.gov.cn/yzygj/s7652/201806/41974899de984947b8faef92a15e9172.shtml.
18. 中华预防医学会公共卫生眼科分会, 北京预防医学会公共卫生眼科学专委会. 关于加强儿童青少年近视防控用眼行为干预的倡议及实施方法共识(2023)[J]. 中华实验眼科杂志, 2023, 41(4): 297-302. DOI: 10.3760/cma.j.cn115989-20230102-00002.Chinese Preventive Medicine Association Public Health Ophthalmology Branch, Beijing Preventive Medicine Association Public health Ophthalmology Special Committee. Consensus on enhancing eye-use behavior interventions for myopia prevention and control of children and adolescents (2023): an extraordinary prescription for eye-use behavior intervention[J]. Chin J Exp Ophthalmol, 2023, 41(4): 297-302. DOI: 10.3760/cma.j.cn115989-20230102-00002.
19. 《低浓度硫酸阿托品防控近视进展眼用制剂制备的专家共识(2023)》专家组, 上海市眼镜行业协会, 上海市医学会视光学专科分会. 低浓度硫酸阿托品防控近视进展眼用制剂制备的专家共识(2023)[J]. 中华实验眼科杂志, 2023, 41(3): 201-205. DOI: 10.3760/cma.j.cn115989-20230120-00023.Expert Group of Expert Consensus on the Preparation of Ophthalmic Preparations for the Prevention and Control of Myopia Progression with Low Concentration Atropine Sulfate (2023) , Shanghai Eyeglasses Industry Association, Shanghai Medical Association Optometry Branch. Experts consensus on preparation of low-concentration atropine sulfate for myopia progression control (2023)[J]. Chin J Exp Ophthalmol, 2023, 41(3): 201-205. DOI: 10.3760/cma.j.cn115989-20230120-00023.
20. 《重复低强度红光照射辅助治疗儿童青少年近视专家共识(2022)》专家组. 重复低强度红光照射辅助治疗儿童青少年近视专家共识(2022)[J]. 中华实验眼科杂志, 2022, 40(7): 599-603. DOI: 10.3760/cma.j.cn115989-20220616-00279.Expert Consensus on Repeated low-intensity red light irradiation for the Adjuvant Treatment of Myopia in Children and Adolescents (2022). Expert consensus on repeated low-level red-light as an alternative treatment for childhood myopia (2022)[J]. Chin J Exp Ophthalmol, 2022, 40(7): 599-603. DOI: 10.3760/cma.j.cn115989-20220616-00279.
21. 中华中医药学会眼科分会. 中医药防控儿童青少年近视指南(社区医生与校医版)[J]. 中国中医眼科杂志, 2021, 31(7): 461-465. DOI: 10.13444/j.cnki.zgzyykzz.2021.07.001.Ophthalmology Branch, Chinese Society of Traditional Chinese Medicine. Guidelines on prevention and control of myopia in children and adolescents with traditional Chinese medicine (community doctor and school doctor edition)[J]. Chinese Journal of Chinese Ophthalmology, 2021, 31(7): 461-465. DOI: 10.13444/j.cnki.zgzyykzz.2021.07.001.
22. 中华中医药学会眼科分会. 中医药防控儿童青少年近视指南(学生与家长版)[J]. 中国中医眼科杂志, 2021, 31(6): 385-389. DOI: 10.13444/j.cnki.zgzyykzz.2021.06.001.Ophthalmology Branch, Chinese Society of Traditional Chinese Medicine. Guidelines on prevention and control of myopia in children and adolescents with traditional Chinese medicine (students and parents edition)[J]. Chinese Journal of Chinese Ophthalmology, 2021, 31(7): 461-465. DOI: 10.13444/j.cnki.zgzyykzz.2021.07.001. DOI: 10.13444/j.cnki.zgzyykzz.2021.06.001.
23. Cai XB, Shen SR, Chen DF, et al. An overview of myopia genetics[J/OL]. Exp Eye Res, 2019, 188: 107778[2019-08-28]. https://pubmed.ncbi.nlm.nih.gov/31472110/. DOI: 10.1016/j.exer.2019.107778.
24. Tedja MS, Haarman AEG, Meester-Smoor MA, et al. IMI-myopia genetics report[J]. Invest Ophthalmol Vis Sci, 2019, 60(3): 89-105. DOI: 10.1167/iovs.18-25965.
25. Haarman AEG, Thiadens AAHJ, van Tienhoven M, et al. Whole exome sequencing of known eye genes reveals genetic causes for high myopia[J]. Hum Mol Genet, 2022, 31(19): 3290-3298. DOI: 10.1093/hmg/ddac113.
26. Flitcroft I, Ainsworth J, Chia A, et al. IMI-management and investigation of high myopia in infants and young children[J]. Invest Ophthalmol Vis Sci, 2023, 64(6): 3. DOI: 10.1167/iovs.64.6.3.
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