Everything You Need to Know About Myopic Macular Degeneration

Myopic macular degeneration (MMD) is a type of macular degeneration. It occurs when severe nearsightedness (myopia) causes physical changes to the eye. The type of severe myopia that causes MMD is called pathological myopia.^1,2

In people with pathological myopia, the eyeball gradually gets longer. This damages the structures in the back of the eye (the macula). The macula keeps vision sharp, so damage to this area leads to problems seeing.^1,3

Myopia is common, and many people have milder forms of nearsightedness. But in people with MMD, myopia is severe, tends to get worse over time, and may lead to irreversible vision loss. About 3 out of every 100 people worldwide have MMD.^1,2

Who gets MMD?

Doctors believe MMD is caused by a combination of genetic (inherited) and environmental factors. People who are older and people with more severe myopia are at higher risk of developing the condition.²

Symptoms of myopic macular degeneration

MMD and age-related macular degeneration (AMD) have similar symptoms. However, they are different conditions. In AMD, changes to the macula happen due to aging. MMD can occur in younger adults and children.³

Symptoms of myopic macular degeneration include:³

• Seeing poorly, even with glasses
• Seeing wavy lines that should appear straight
• Having a blind spot in the center of your vision
• Having trouble seeing colors
• Being sensitive to bright light
• Having trouble seeing in low light
• Trouble with reading, driving, or cooking due to poor vision

How is it diagnosed?

Your eye doctor will need to perform a dilated eye exam to look for signs of MMD. These signs of MMD may include:³

• Posterior staphyloma – Thinning and bulging of the outside layer of the eye (the sclera)
• Peripapillary atrophy – Damage to the optic nerve
• Chorioretinal atrophy – Dying cells in the retina
• Choroidal neovascularization (CNV) – Abnormal, leaky blood vessels growing on the retina
• Lacquer cracks – Breaks in the layer between the blood vessel layer (choroid) and the retina
• Fuchs spots – Scarring of the macula that causes missing spots in central vision

How is it treated?

There are no treatments for MMD, but there are treatments for one of its most common and damaging symptoms, CNV. CNV is treated with anti-VEGF drugs, the same drugs that treat wet macular degeneration.^2,4

Studies show the anti-VEGF drugs ranibizumab and bevacizumab are equally effective in improving vision in people with MMD. These drugs seem to work better than photodynamic therapy (PDT), another treatment for MMD. Eye surgery is another treatment option that may help some people.⁴

If you are at risk for MMD, your doctor may recommend myopia control strategies. These methods are designed to keep myopia from getting worse. They include:⁵

• Wearing special myopia control glasses or contact lenses that change how light focuses in the eye
• Atropine eye drops
• Wearing a special type of contact lens overnight (orthokeratology, or ortho-k)
• Spending more time outdoors
• Reducing time spent reading and on a computer

Living with myopic macular degeneration

If you already have MMD, your doctor may ask you to follow several steps to keep your vision as healthy as possible. They may recommend that you:^3,6

• Check your Amsler grid daily, and call right away if lines look wavy
• Use low vision aids such as magnifiers, large-print books, and talking devices
• Improve your indoor lighting
• Wear high-index glasses or contact lenses

Your doctor may also recommend some lifestyle changes that can help preserve what vision you have left. These changes may include the following:³

• Stop smoking
• Eat a diet rich in leafy green vegetables, fruit, and low-fat foods
• Exercise for 30 to 60 minutes a day
• Maintain a healthy body weight
• Wear sunglasses

If you are living with MMD, you are at higher risk of retinal detachment. Call your doctor right away if you notice signs of retinal detachment, such as new floaters, flashing lights, or vision changes.¹