Clinical profile and fundus changes in pathological myopia: a prospective study from south india

Abstract

associated with significant visual morbidity due to structural changes in the posterior segment of the eye. With increasing prevalence, especially among younger populations, early identification of associated fundus changes and complications is essential for timely intervention and prevention of vision loss. Methods: This prospective study was conducted over a period of six months (January 2024 to June 2024). A total of 100 patients (200 eyes) with pathological myopia (refractive error > -6.0 D) were included. All patients underwent detailed ophthalmic evaluation including visual acuity assessment, slit-lamp examination, intraocular pressure measurement, A-scan biometry, keratometry, and fundus examination. Patients with abnormal corneal curvature and other ocular pathologies were excluded. Posterior segment changes and peripheral retinal degenerations were documented and analyzed. Results: The highest incidence of pathological myopia was observed in the 11–20 years age group (32%), with a female predominance (54%). Most patients had a refractive error between -6 D and -9 D (41.5%) and axial length ranging from 26 28 mm (34%). The majority of patients had best corrected visual acuity between 6/6 and 6/18 (60%). Common fundus findings included tessellated fundus (42%), temporal crescent (40%), peripapillary atrophy (25%), and posterior staphyloma (21%). Lacquer cracks were observed in 11% and Fuchs spots in 7.5% of cases. Peripheral retinal degeneration was most commonly lattice degeneration (5%). Complications such as retinal detachment (5%), primary open-angle glaucoma (5%), and retinitis pigmentosa (4%) were also noted. Conclusion: Pathological myopia is associated with a high prevalence of degenerative fundus changes, particularly in eyes with higher refractive error and axial length. Early detection through meticulous fundus examination and regular follow-up is crucial to prevent vision-threatening complications and preserve visual function.