11/10/2023 0 Comments Pathological myopia signs![]() PCA consists in well-defined, grayish white lesion(s), mainly localized within the macular area and around the optic disk. However, this should be carefully addressed by physicians given the relevant prognostic implications of the origin of atrophic lesions. The differentiation of PCA due to pathologic myopia, and chorioretinal atrophic lesions due to MFC may be challenging. The authors define category A0 in the absence of any particular atrophic change in the fundus examination category A1 for cases with fundus tessellation category A2 for cases with diffuse chorioretinal atrophy category A3 for patients with PCA and category A4 for cases with complete macular atrophy ( Figure 1). Ruiz-Medrano et al recently published a simplified classification of retinal atrophic patterns associated with high myopia ( 2). The aim of the present manuscript is to summarize the key multimodal imaging findings in cases with MFC and the main helpful tips to differentiate these from those of PCA and myopic CNV. Thus, the ability of clinicians to differentiate findings suitable for pathologic myopia or MFC is key to provide an accurate prognosis and follow-up plan for patients, and thus to consider the addition of immunosuppressive therapy in cases with visual threatening atrophic and neovascular changes. Also, MFC may eventually associate inflammatory choroidal neovascularization in about one third of cases through the follow-up ( 8, 11– 13). Acute inflammatory lesions appear as single or multiple yellow-grayish spots that may evolve progressively into punched-out atrophic scars, with a variable degree of pigmentation. They represent a form of non-infectious posterior uveitis characterized by a chronic, recurrent and usually bilateral disease ( 8– 10). Thus, both terms are generally used indistinctly and a consensus to differentiate both entities remains undetermined. Idiopathic Multifocal Choroiditis (MFC) and Punctate Inner Choroidopathy share clinical, structural and prognostic insights. PCA may develop from lacquer cracks (Lc), within areas of advanced diffuse chorioretinal atrophy, and along the border of posterior staphyloma ( 6, 7). PCA can be observed as whitish well-defined lesions of various shapes and configurations, probably related to complete closure of the choriocapillaris. The term pathologic myopia is usually used to describe patients with myopia and structural changes in the posterior pole ( 3), including vitreoretinal tractional changes, choroidal neovascularization (CNV) and chorioretinal atrophy ( 2, 4, 5).įocusing on chorioretinal atrophic changes related to pathologic myopica we can divide them into fundus tessellation, diffuse chorioretinal atrophy, and patchy chorioretinal atrophy (PCA). The sociosanitary impact of myopia is increasing worldwide with an estimated overall prevalence of 2.5 billion cases, comprising 10–30 % in the adult population in many countries and 80–90% in young adults in some parts or East and Southest Asia ( 1, 2). Myopia is a medical condition characterized by blurred distance vision because of images of distant objects focusing in front of the retina, what is mostly due to excessive elongation of the eye. The aim of the present manuscript is to summarize and illustrate the main multimodal imaging features of these diseases. Thus, differentiation of inflammatory lesions due to MFC or neurodenegerative lesions due to pathologic myopic is key in order to establish a particular prognosis, follow-up schedule, and therapeutic approach. ![]() ![]() Acute and chronic chorioretinal atrophic changes are the hallmark feature of MFC, with CNV developing in almost one third of cases. Multifocal choroiditis (MFC) is one of the most frequent noninfectious posterior uveitis, and epidemiologically typically affects young myopic females. Pathologic myopia refers to myopic patients with structural changes in the posterior pole including different patterns of chorioretinal atrophy, choroidal neovascularization (CNV) and vitreomacular tractional diseases. ![]() Myopia represents a major socioeconomic burden with an increasing prevalence worldwide.
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