Research progress on clinical classification of pathologic myopia related fundus lesions_Chinese Journal of Ocular Fundus Diseases

Authors：

Li Menghan ^1,2 , Chen Qiuying ^1,2 , Fan Ying ¹ ,  Xu Xun ¹

1. Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China;
2. Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China;

Corresponding author：

Xu Xun, Email: drxuxun@tom.com

Keywords：

Review; Myopia, degenerative; Posterior staphyloma; Myopic maculopathy

DOI：

10.3760/cma.j.cn511434-20210628-00345

Video：

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Abstract Full text Figures/Tables Video References Cited by

The main fundus changes of pathologic myopia (PM) are posterior staphyloma (PS) and myopic maculopathy (MM), which includes myopic atrophy maculopathy (MAM), myopic tractional maculopathy (MTM), myopic neovascular maculopathy (MNM) and so on. The clinical manifestations of PM-related fundus lesions are complex, and the classification of PM has been a research hotspot in recent years. The proposal of each classification shows an increasing understanding of PM, and each classification has its advantages but also imperfections. For MM, it is recommended to refine the MTM classification based on the ATN classification and adjust it according to the internal correlation between MAM and MNM. The rapid development of modern imaging technology will promote the continuous update of the classification, and its further improvement will also help to understand the development process of PM, which has important clinical value in preventing its occurrence and progression.

Citation： Li Menghan, Chen Qiuying, Fan Ying, Xu Xun. Research progress on clinical classification of pathologic myopia related fundus lesions. Chinese Journal of Ocular Fundus Diseases, 2022, 38(9): 775-778. doi: 10.3760/cma.j.cn511434-20210628-00345 Copy

1.	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.
2.	Chang L, Pan CW, Ohno-Matsui K, et al. Myopia-related fundus changes in Singapore adults with high myopia[J]. Am J Ophthalmol, 2013, 155(6): 991-999. DOI: 10.1016/j.ajo.2013.01.016.
3.	Kim M, Choung HK, Lee KM, et al. Longitudinal changes of optic nerve head and peripapillary structure during childhood myopia progression on OCT: Boramae myopia cohort study report 1[J]. Ophthalmology, 2018, 125(8): 1215-1223. DOI: 10.1016/j.ophtha.2018.01.026.
4.	Hu G, Chen Q, Xu X, et al. Morphological characteristics of the optic nerve head and choroidal thickness in high myopia[J]. Invest Ophthalmol Vis Sci, 2020, 61(4): 46. DOI: 10.1167/iovs.61.4.46.
5.	Ohno-Matsui K. Pathologic myopia[J]. Asia Pac J Ophthalmol (Phila), 2016, 5(6): 415-423. DOI: 10.1097/apo.0000000000000230.
6.	Ohno-Matsui K, Jonas JB. Posterior staphyloma in pathologic myopia[J]. Prog Retin Eye Res, 2019, 70: 99-109. DOI: 10.1016/j.preteyeres.2018.12.001.
7.	聂芬, 欧阳君怡, 罗丽佳, 等. 病理性近视后巩膜葡萄肿的研究进展[J]. 中华眼底病杂志, 2020, 36(12): 977-982. DOI: 10.3760/cma.j.cn511434-20191202-00020.Nie F, Ouyang JY, Luo LJ, et al. Progressive research of posterior staphyloma in pathological myopia[J]. Chin J Ocul Fundus Dis, 2020, 36(12): 977-982. DOI: 10.3760/cma.j.cn511434-20191202-00020.
8.	Curtin BJ. The posterior staphyloma of pathologic myopia[J]. Trans Am Ophthalmol Soc, 1977, 75: 67-86.
9.	Ohno-Matsui K. Proposed classification of posterior staphylomas based on analyses of eye shape by three-dimensional magnetic resonance imaging and wide-field fundus imaging[J]. Ophthalmology, 2014, 121(9): 1798-1809. DOI: 10.1016/j.ophtha.2014.03.035.
10.	Shinohara K, Shimada N, Moriyama M, et al. Posterior staphylomas in pathologic myopia imaged by widefield optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2017, 58(9): 3750-3758. DOI: 10.1167/iovs.17-22319.
11.	Zheng F, Wong CW, Sabanayagam C, et al. Prevalence, risk factors and impact of posterior staphyloma diagnosed from wide-field optical coherence tomography in singapore adults with high myopia[J/OL]. Acta Ophthalmol, 2021, 99(2): e144-e153[2020-06-29]. https://pubmed.ncbi.nlm.nih.gov/32602252/. DOI: 10.1111/aos.14527.
12.	Fang Y, Du R, Nagaoka N, et al. OCT-based diagnostic criteria for different stages of myopic maculopathy[J]. Ophthalmology, 2019, 126(7): 1018-1032. DOI: 10.1016/j.ophtha.2019.01.012.
13.	Ellabban AA, Tsujikawa A, Matsumoto A, et al. Three-dimensional tomographic features of dome-shaped macula by swept-source optical coherence tomography[J]. Am J Ophthalmol, 2013, 155(2): 320-328. DOI: 10.1016/j.ajo.2012.08.007.
14.	Ellabban AA, Tsujikawa A, Muraoka Y, et al. Dome-shaped macular configuration: longitudinal changes in the sclera and choroid by swept-source optical coherence tomography over two years[J]. Am J Ophthalmol, 2014, 158(5): 1062-1070. DOI: 10.1016/j.ajo.2014.08.006.
15.	Ruiz-Medrano J, Montero JA, Flores-Moreno I, et al. Myopic maculopathy: current status and proposal for a new classification and grading system (ATN)[J]. Prog Retin Eye Res, 2019, 69: 80-115. DOI: 10.1016/j.preteyeres.2018.10.005.
16.	Ruiz-Medrano J, Flores-Moreno I, Ohno-Matsui K, et al. Validation of the recently developed ATN classification and grading system for myopic maculopathy[J]. Retina, 2020, 40(11): 2113-2118. DOI: 10.1097/iae.0000000000002725.
17.	Zhang RR, Yu Y, Hou YF, et al. Intra- and interobserver concordance of a new classification system for myopic maculopathy[J]. BMC Ophthalmol, 2021, 21(1): 187. DOI: 10.1186/s12886-021-01940-4.
18.	Hayashi K, Ohno-Matsui K, Shimada N, et al. Long-term pattern of progression of myopic maculopathy: a natural history study[J]. Ophthalmology, 2010, 117(8): 1595-1611. DOI: 10.1016/j.ophtha.2009.11.003.
19.	Avila MP, Weiter JJ, Jalkh AE, et al. Natural history of choroidal neovascularization in degenerative myopia[J]. Ophthalmology, 1984, 91(12): 1573-1581. DOI: 10.1016/s0161-6420(84)34116-1.
20.	Yan YN, Wang YX, Yang Y, et al. Ten-year progression of myopic maculopathy: the Beijing eye study 2001-2011[J]. Ophthalmology, 2018, 125(8): 1253-1263. DOI: 10.1016/j.ophtha.2018.01.035.
21.	Fang Y, Yokoi T, Nagaoka N, et al. Progression of myopic maculopathy during 18-year follow-up[J]. Ophthalmology, 2018, 125(6): 863-877. DOI: 10.1016/j.ophtha.2017.12.005.
22.	Zhao X, Ding X, Lyu C, et al. Morphological characteristics and visual acuity of highly myopic eyes with different severities of myopic maculopathy[J]. Retina, 2020, 40(3): 461-467. DOI: 10.1097/iae.0000000000002418.
23.	Chen Q, He J, Hu G, et al. Morphological characteristics and risk factors of myopic maculopathy in an older high myopia population-based on the new classification system (ATN)[J]. Am J Ophthalmol, 2019, 208: 356-366. DOI: 10.1016/j.ajo.2019.07.010.
24.	Li J, Liu B, Li Y, et al. Clinical characteristics of eyes with different grades of myopic traction maculopathy: based on the new classification system[J]. Retina, 2021, 41(7): 1496-1501. DOI: 10.1097/iae.0000000000003043.
25.	Takahashi H, Tanaka N, Shinohara K, et al. Importance of paravascular vitreal adhesions for development of myopic macular retinoschisis detected by ultra-widefield OCT[J]. Ophthalmology, 2021, 128(2): 256-265. DOI: 10.1016/j.ophtha.2020.06.063.
26.	Shimada N, Tanaka Y, Tokoro T, et al. Natural course of myopic traction maculopathy and factors associated with progression or resolution[J]. Am J Ophthalmol, 2013, 156(5): 948-957. DOI: 10.1016/j.ajo.2013.06.031.
27.	Parolini B, Palmieri M, Finzi A, et al. The new myopic traction maculopathy staging system[J]. Eur J Ophthalmol, 2021, 31(3): 1299-1312. DOI: 10.1177/1120672120930590.

1. 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.
2. Chang L, Pan CW, Ohno-Matsui K, et al. Myopia-related fundus changes in Singapore adults with high myopia[J]. Am J Ophthalmol, 2013, 155(6): 991-999. DOI: 10.1016/j.ajo.2013.01.016.
3. Kim M, Choung HK, Lee KM, et al. Longitudinal changes of optic nerve head and peripapillary structure during childhood myopia progression on OCT: Boramae myopia cohort study report 1[J]. Ophthalmology, 2018, 125(8): 1215-1223. DOI: 10.1016/j.ophtha.2018.01.026.
4. Hu G, Chen Q, Xu X, et al. Morphological characteristics of the optic nerve head and choroidal thickness in high myopia[J]. Invest Ophthalmol Vis Sci, 2020, 61(4): 46. DOI: 10.1167/iovs.61.4.46.
5. Ohno-Matsui K. Pathologic myopia[J]. Asia Pac J Ophthalmol (Phila), 2016, 5(6): 415-423. DOI: 10.1097/apo.0000000000000230.
6. Ohno-Matsui K, Jonas JB. Posterior staphyloma in pathologic myopia[J]. Prog Retin Eye Res, 2019, 70: 99-109. DOI: 10.1016/j.preteyeres.2018.12.001.
7. 聂芬, 欧阳君怡, 罗丽佳, 等. 病理性近视后巩膜葡萄肿的研究进展[J]. 中华眼底病杂志, 2020, 36(12): 977-982. DOI: 10.3760/cma.j.cn511434-20191202-00020.Nie F, Ouyang JY, Luo LJ, et al. Progressive research of posterior staphyloma in pathological myopia[J]. Chin J Ocul Fundus Dis, 2020, 36(12): 977-982. DOI: 10.3760/cma.j.cn511434-20191202-00020.
8. Curtin BJ. The posterior staphyloma of pathologic myopia[J]. Trans Am Ophthalmol Soc, 1977, 75: 67-86.
9. Ohno-Matsui K. Proposed classification of posterior staphylomas based on analyses of eye shape by three-dimensional magnetic resonance imaging and wide-field fundus imaging[J]. Ophthalmology, 2014, 121(9): 1798-1809. DOI: 10.1016/j.ophtha.2014.03.035.
10. Shinohara K, Shimada N, Moriyama M, et al. Posterior staphylomas in pathologic myopia imaged by widefield optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2017, 58(9): 3750-3758. DOI: 10.1167/iovs.17-22319.
11. Zheng F, Wong CW, Sabanayagam C, et al. Prevalence, risk factors and impact of posterior staphyloma diagnosed from wide-field optical coherence tomography in singapore adults with high myopia[J/OL]. Acta Ophthalmol, 2021, 99(2): e144-e153[2020-06-29]. https://pubmed.ncbi.nlm.nih.gov/32602252/. DOI: 10.1111/aos.14527.
12. Fang Y, Du R, Nagaoka N, et al. OCT-based diagnostic criteria for different stages of myopic maculopathy[J]. Ophthalmology, 2019, 126(7): 1018-1032. DOI: 10.1016/j.ophtha.2019.01.012.
13. Ellabban AA, Tsujikawa A, Matsumoto A, et al. Three-dimensional tomographic features of dome-shaped macula by swept-source optical coherence tomography[J]. Am J Ophthalmol, 2013, 155(2): 320-328. DOI: 10.1016/j.ajo.2012.08.007.
14. Ellabban AA, Tsujikawa A, Muraoka Y, et al. Dome-shaped macular configuration: longitudinal changes in the sclera and choroid by swept-source optical coherence tomography over two years[J]. Am J Ophthalmol, 2014, 158(5): 1062-1070. DOI: 10.1016/j.ajo.2014.08.006.
15. Ruiz-Medrano J, Montero JA, Flores-Moreno I, et al. Myopic maculopathy: current status and proposal for a new classification and grading system (ATN)[J]. Prog Retin Eye Res, 2019, 69: 80-115. DOI: 10.1016/j.preteyeres.2018.10.005.
16. Ruiz-Medrano J, Flores-Moreno I, Ohno-Matsui K, et al. Validation of the recently developed ATN classification and grading system for myopic maculopathy[J]. Retina, 2020, 40(11): 2113-2118. DOI: 10.1097/iae.0000000000002725.
17. Zhang RR, Yu Y, Hou YF, et al. Intra- and interobserver concordance of a new classification system for myopic maculopathy[J]. BMC Ophthalmol, 2021, 21(1): 187. DOI: 10.1186/s12886-021-01940-4.
18. Hayashi K, Ohno-Matsui K, Shimada N, et al. Long-term pattern of progression of myopic maculopathy: a natural history study[J]. Ophthalmology, 2010, 117(8): 1595-1611. DOI: 10.1016/j.ophtha.2009.11.003.
19. Avila MP, Weiter JJ, Jalkh AE, et al. Natural history of choroidal neovascularization in degenerative myopia[J]. Ophthalmology, 1984, 91(12): 1573-1581. DOI: 10.1016/s0161-6420(84)34116-1.
20. Yan YN, Wang YX, Yang Y, et al. Ten-year progression of myopic maculopathy: the Beijing eye study 2001-2011[J]. Ophthalmology, 2018, 125(8): 1253-1263. DOI: 10.1016/j.ophtha.2018.01.035.
21. Fang Y, Yokoi T, Nagaoka N, et al. Progression of myopic maculopathy during 18-year follow-up[J]. Ophthalmology, 2018, 125(6): 863-877. DOI: 10.1016/j.ophtha.2017.12.005.
22. Zhao X, Ding X, Lyu C, et al. Morphological characteristics and visual acuity of highly myopic eyes with different severities of myopic maculopathy[J]. Retina, 2020, 40(3): 461-467. DOI: 10.1097/iae.0000000000002418.
23. Chen Q, He J, Hu G, et al. Morphological characteristics and risk factors of myopic maculopathy in an older high myopia population-based on the new classification system (ATN)[J]. Am J Ophthalmol, 2019, 208: 356-366. DOI: 10.1016/j.ajo.2019.07.010.
24. Li J, Liu B, Li Y, et al. Clinical characteristics of eyes with different grades of myopic traction maculopathy: based on the new classification system[J]. Retina, 2021, 41(7): 1496-1501. DOI: 10.1097/iae.0000000000003043.
25. Takahashi H, Tanaka N, Shinohara K, et al. Importance of paravascular vitreal adhesions for development of myopic macular retinoschisis detected by ultra-widefield OCT[J]. Ophthalmology, 2021, 128(2): 256-265. DOI: 10.1016/j.ophtha.2020.06.063.
26. Shimada N, Tanaka Y, Tokoro T, et al. Natural course of myopic traction maculopathy and factors associated with progression or resolution[J]. Am J Ophthalmol, 2013, 156(5): 948-957. DOI: 10.1016/j.ajo.2013.06.031.
27. Parolini B, Palmieri M, Finzi A, et al. The new myopic traction maculopathy staging system[J]. Eur J Ophthalmol, 2021, 31(3): 1299-1312. DOI: 10.1177/1120672120930590.

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