The evolving role of OCT in pathologic myopia

Authors

  • Mark Greve, MD, FRCSC
  • Mark Seamone, MD, FRCSC
  • Carl Shen, MD, FRCSC

DOI:

https://doi.org/10.58931/cect.2022.115

Abstract

The global burden of myopia represents a significant public health concern that is expected to continue to increase in the near future. It is estimated that 50% of the world’s population will be affected by myopia by 2050, with a disproportionately high prevalence in Asia. High myopia, where the spherical equivalent refractive error is equal to or higher than 6.00 diopters, is expected to increase in prevalence from 2.7% to 10% during this period. The severity of myopia is of paramount concern to clinicians as higher levels are associated with pathologic myopia (PM) and increased risk of vision loss. Pathologic myopia, as recently defined by the International Myopia Institute, is an excessive axial elongation associated with myopia that leads to structural changes in the posterior segment of the eye that can lead to loss of best-corrected visual acuity. These structural changes and their complications include posterior staphyloma, myopic choroidal neovascularization, myopic maculopathy, myopic traction maculopathy, dome shaped maculopathy, optic disc changes and glaucoma associated with myopia, and retinal detachments.

The advent of optical coherence tomography (OCT) has facilitated the characterization, diagnosis, and management of several of these complications associated with PM and will be the focus of this article. Imaging the highly myopic eye represents a crucial step in the identification of these complications and poses its own unique challenges. Researchers have demonstrated the advantage of 3D cube scans in the detection of pathology compared to 1- and 5-line rasters. Using vertical scanning patterns aligning where the radius of curvature is larger relative to the horizontal plane of the myopic eye can minimize associated artifacts. Wide scans, facilitated by emerging technologies such as swept- source OCT and ultra wide-field OCT, are useful in cases of PM where the pathology can initiate peripherally.

Author Biographies

Mark Greve, MD, FRCSC

Dr. Mark Greve attended and received his Doctor of Medicine in 1983–1988 from the University of Saskatchewan. He then began his Ophthalmology Residency in 1988, at the University of Saskatchewan, completing his Residency in 1992. Dr. Greve spent the next two years, till 1994, completing his Medical/Surgical Retina Fellowship at Louisiana State University. Dr. Greve is currently an Associate Clinical Professor with the University of Alberta and is Chief of Vitreoretinal Surgery.

Mark Seamone, MD, FRCSC

Dr. Mark Seamone completed a 4-year BSc in Biology at Acadia University. Following his undergraduate, he completed a MSc in Immunology and his Doctor of Medicine as a member of the Leaders in Medicine Program, University of Calgary. He then completed a 5-year Ophthalmology residency at Dalhousie University. Dr. Seamone concluded his training by completing a 2-year medical and surgical Vitreoretinal fellowship at the University of Alberta. He is a Fellow of the Royal College of Physicians and Surgeons of Canada. He is an Assistant Clinical Professor in the Department of Ophthalmology, University of Alberta, and serves as the Fellowship Director for the University of Alberta Vitreoretinal Fellowship Program.

Carl Shen, MD, FRCSC

Dr. Carl Shen completed his Bachelor of Medical Sciences at Western University followed by his Doctorate of Medicine from the University of Toronto and subsequent residency training in ophthalmology at McMaster University. He is currently completing his vitreo-retinal fellowship at the University of Alberta.

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Published

2022-06-01

How to Cite

1.
Greve M, Seamone M, Shen C. The evolving role of OCT in pathologic myopia. Can Eye Care Today [Internet]. 2022 Jun. 1 [cited 2024 Dec. 13];1(1):8–13. Available from: https://canadianeyecaretoday.com/article/view/1-1-1

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Articles