High myopia patients—especially those older than age 55—are at a significant risk of age-related macular degeneration (AMD), a new study shows. Researchers set out to analyze the frequency and phenotypic variation of AMD in subjects with high myopia and to describe both the clinical course and response to treatment of neovascularization. The investigators found that neovascularization in highly myopic (defined as having an axial length of 25.5mm or greater) AMD patients required more injections in the first year than in those without AMD.

They looked at a total of 104 eyes of 54 patients older than 55 at five retina tertiary referral centers and followed them for approximately one year. The estimated AMD frequency in high myopia patients was 11.9%. A total of 34 eyes were diagnosed with drusen, 22 with reticular pseudodrusen and 28 with both. Geographic atrophy was seen in 20 eyes. Neovascularization was detected in half of the eyes studied, most frequently type 1.

Overall, neovascularization was treated with approximately 4.6 injections of an anti-vascular endothelial growth factor (VEGF) drug. Eyes with treatment-naïve neovascularization at baseline required fewer—only approximately 3.8 injections. Both, however, exceeded the injection number in the patients without AMD, who only needed 1.8 to 3.6 injections in the first year.

Corbelli E, Parravano M, Sacconi R, et al. Prevalence and phenotypes of age-related macular degeneration in eyes with high myopia. Invest Ophthalmol Vis Sci. 2019;60(5):1394-402.