Management of Myopic Maculopathy: A Review

Myopia, including pathologic myopia, has seen a significant increase in prevalence in recent years. It is a significant cause of irreversible vision loss worldwide and prediction models demonstrate the substantial future impact on the population. With increased awareness and research, it is possible to prevent blindness on a large scale in the younger, productive age group affected by myopic maculopathy. The vision threatening manifestations of pathologic myopic include myopic choroidal neovascularization, macular atrophy, maculoschisis, macular hole, and retinal detachment. Myopic traction maculopathy is a progressive manifestation of pathologic myopia and its treatment includes pars plana vitrectomy, macular buckle, or a combination. In this article we aim to review the diagnosis, clinical characteristics, and treatment of myopic maculopathy with an emphasis on recent development in the surgical management of myopic traction maculopathy. We discuss commercially available macular buckles, along with potential advantages to the use of macular buckle in myopic maculopathy. We review the new myopic traction maculopathy staging system and its role in determining surgical management of these complex cases.