Myopic Macular Degeneration Treatment
Myopic macular degeneration (MMD) is a very severe form of nearsightedness that damages the retina. Although it is related to myopia, not everyone with myopia will develop MMD. Over time, the eyeball becomes elongated, stretching and damaging the retina and underlying support structures. In up to 10 percent of individuals with MMD, choroidal neovascularization, or CNV, develops.1 This is when new abnormal blood vessels arise from the choroid underneath the retina, which can then leak or bleed, causing vision loss.
Preventing vision loss progression
Right now, there is no way to completely cure those with MMD, but there are treatments to address many of the associated complications of the condition in order to prevent further vision loss. It’s important that you see your eye doctor regularly so that when any complications do arise, they can be treated quickly and appropriately.
Visual function treatment
Contact lenses or glasses can help improve vision and visual function in those with MMD, but glasses don’t actually address the MMD disease process itself. If you wear glasses for MMD, the lenses tend to be very thick due to a high amount of nearsightedness. Laser vision surgery is not an option to treat vision loss associated with MMD because these lasers are focused on reshaping the cornea, which is located in the front part of the eye.
There are some treatments for MMD that used to be more prevalent but have fallen out of favor due to new breakthroughs.
Laser photocoagulation, a form of laser cautery, was used to treat CNV related to MMD, but treatment benefits were not long-term and recurrence rates were high.1
Photodynamic therapy (PDT)
Photodynamic therapy (PDT), another laser procedure involving the use of a photoactive dye injected into the bloodstream, was also used as a treatment for CNV; while it helped patients in the short-term, visual acuity was found to worsen over time.1 Both of these were primarily used prior to the emergence of anti-VEGF treatments.
In MMD, abnormal blood vessels can grow under the retina and leak. This growth is promoted by a protein called vascular endothelial growth factor (VEGF), and anti-VEGF drugs can be given to slow down the growth of these blood vessels.2 These drugs are given via injection into the eye by an ophthalmologist. These are typically given monthly for several months and then continued on a schedule determined by your doctor depending on your disease progression.
Difference between MMD and wet AMD
Fortunately, patients being treated for CNV related to MMD usually need fewer injections compared to those being treated for CNV in the setting of wet age-related macular degeneration. In fact, many patients with MMD may remain stable for months or even years without additional injections as long as they are being monitored by an ophthalmologist regularly.
Complications of myopia
Individuals who have severe myopia are more at risk of developing cataracts. If these develop and interfere with your daily activities, surgery is available to remove them.
Myopia – both mild and severe – is associated with an increased risk of glaucoma, a condition in which high eye pressures result in nerve damage to the eye and vision loss. If you are at high risk or if you develop glaucoma, you might be prescribed specific eye drops that can help lower eye pressure and decrease the risk of disease progression.2 Talk with your doctor about your risk, and if you have glaucoma, ask your doctor how to use the eye drops, and how often, in addition to seeing the eye doctor for regular monitoring.
Retinal tears and retinal detachment
Having MMD significantly increases your risk of retinal tears and retinal detachment because of the elongation and stretching of the eye. If a tear develops, you may see flashes of light or floaters in your vision. If a detachment occurs, you may notice a dark curtain spreading across your field of vision, which can start from any direction. If caught fairly soon, surgery can repair a detached retina in order to prevent further vision loss and hopefully restore some vision.2
MMD can cause you to be sensitive to bright light. Wearing sunglasses and wide-brimmed hats can help. It can be helpful to wear sunglasses whenever you go outside, to protect your eyes from UV light.
If you have been diagnosed with MMD, talk with your doctor about where your disease is at right now, the projected course of your condition, and what you can do to take steps to preserve the vision you have and what possible next steps might be. They will be able to tell you more about what treatments are available and best for you, and what other new treatments or diagnostic tests might be on the horizon for MMD.