Updates on Myopia: A Clinical Perspective

309 Pages·2020·8.724 MB·English

by  Marcus Ang, Tien Y. Wong

Updates on Myopia
A Clinical Perspective
Marcus Ang
Tien Y. Wong
Editors
Updates on Myopia
Marcus Ang • Tien Y. Wong
Editors
Updates on Myopia
A Clinical Perspective
Editors
Marcus Ang Tien Y. Wong
Singapore National Eye Center Singapore National Eye Center
Duke-NUS Medical School Duke-NUS Medical School
National University of Singapore National University of Singapore
Singapore Singapore
This book is an open access publication.
ISBN 978-981-13-8490-5 ISBN 978-981-13-8491-2 (eBook)
https://doi.org/10.1007/978-981-13-8491-2
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Preface
Myopia is now being recognized as a significant global public health problem that
will affect billions of people in the next decades, especially in Asia. Currently,
pathologic myopia is already a major cause of visual impairment in both Asian and
Western populations. As the prevalence of myopia and pathological myopia
increases around the world, there is increasing need for active prevention of myopia
progression and management of its potential complications.
The purpose of this book is to provide updates on current understanding of myo-
pia, new methods of evaluation of the myopic eye, and a focus on clinical manage-
ment of myopia and its complications. This book will provide a unique perspective
from the current world experts on the subject, with a focus on clinical aspects of
understanding, evaluation, and management of myopia.
Chapter 1 provides a concise summary of all the key points from the book for
busy readers who want a quick overview on clinical myopia. The rest of the book is
comprehensive and provides updates on almost all aspects with regard to myopia.
Chapters 2 and 3 describe epidemiology and economic burden; Chaps. 4 and 5 dis-
cuss genetic and pathogenetic mechanisms; Chaps. 6 to 8 describe risk factors and
ways to prevent myopia development or progression. Next, Chaps. 9 and 10 discuss
pathological myopia and advances (and challenges) in imaging myopic eyes.
Finally, Chaps. 11 to 14 provide clinical pearls of managing myopia complications,
i.e., glaucoma, retina, and choroidal neovascularization in adults.
As new data is constantly emerging, this book was generated with the inputs of
all authors within 6 months to ensure that the evidence shared is as current as pos-
sible. Thus, it is important to keep updated with online material and literature
review. Nonetheless, we hope you will find this book as a useful reference for
optometry students, ophthalmology residents, and eye care professionals to have a
comprehensive update on myopia with a clinical perspective.
Singapore, Singapore Marcus Ang
Singapore, Singapore Tien Y. Wong
v
Acknowledgments
Singapore National Eye Centre, Singapore
Singapore Eye Research Institute, Singapore
Duke National University of Singapore (DUKE NUS), Singapore
Singapore National Eye Centre Myopia Centre, Singapore
PPAANNTTOONNEE 3N0e0uCtral Black C
vii
Contents
1 Introduction and Overview on Myopia: A Clinical Perspective . . . . . . 1
Chee Wai Wong, Noel Brennan, and Marcus Ang
2 Global Epidemiology of Myopia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Saiko Matsumura, Cheng Ching-Yu, and Seang-Mei Saw
3 The Economic and Societal Impact of Myopia and High Myopia . . . . 53
Sharon Yu Lin Chua and Paul J. Foster
4 Understanding Myopia: Pathogenesis and Mechanisms . . . . . . . . . . . . 65
Ranjay Chakraborty, Scott A. Read, and Stephen J. Vincent
5 The Genetics of Myopia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Milly S. Tedja, Annechien E. G. Haarman,
Magda A. Meester-Smoor, Virginie J. M. Verhoeven,
Caroline C. W. Klaver, and Stuart MacGregor
6 Risk Factors for Myopia:
Putting Causal Pathways into a Social Context . . . . . . . . . . . . . . . . . . . 133
Ian G. Morgan, Amanda N. French, and Kathryn A. Rose
7 Prevention of Myopia Onset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Mingguang He, Yanxian Chen, and Yin Hu
8 Clinical Management and Control of Myopia in Children . . . . . . . . . . 187
Audrey Chia and Su Ann Tay
9 Understanding Pathologic Myopia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Kyoko Ohno-Matsui and Jost B. Jonas
10 Imaging in Myopia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Quan V. Hoang, Jacqueline Chua,
Marcus Ang, and Leopold Schmetterer
11 Glaucoma in High Myopia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Jost B. Jonas, Songhomitra Panda-Jonas, and Kyoko Ohno-Matsui
ix
x Contents
12 Clinical Management of Myopia in Adults:
Treatment of Retinal Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Jerry K. H. Lok, Raymond L. M. Wong,
Lawrence P. L. Iu, and Ian Y. H. Wong
13 Clinical Management of Myopia in Adults:
Treatment of Myopic CNV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Shaun Sim, Chee Wai Wong, and Gemmy C. M. Cheung
14 Optical Interventions for Myopia Control . . . . . . . . . . . . . . . . . . . . . . . 289
Wing Chung Tang, Myra Leung, Angel C. K. Wong,
Chi-ho To, and Carly S. Y. Lam
About the Editors
Marcus Ang is consultant ophthalmologist at the Corneal and External Eye

Disease Department of the Singapore National Eye Center (SNEC) and Duke-NUS
Medical School, National University of Singapore, as well as Clinical Director of
the SNEC Myopia Centre. His clinical and research areas of expertise include the
treatment, and prevention of visual impairment in adult myopia. He also has special
research interests in corneal transplantation, such as Descemet membrane endothe-
lial keratoplasty (DMEK) and anterior segment imaging including novel optical
coherence tomography systems for the cornea. Dr. Ang has published over 120
peer-reviewed articles journals, coauthored several book chapters on corneal trans-
plantation, and received numerous international awards.
Tien Y. Wong is Arthur Lim Professor in Ophthalmology and Medical Director at

the Singapore National Eye Center (SNEC). He is concurrently Academic Chair of
Ophthalmology and Vice-Dean of Duke-NUS Medical School, National University
of Singapore. Prior to his current appointments, Prof. Wong was Executive Director
of the Singapore Eye Research Institute; Chairman of the Department of
Ophthalmology, National University of Singapore; Chairman of the Department of
Ophthalmology at the University of Melbourne; and Managing Director of the Centre
for Eye Research Australia, Australia. Professor Wong is a retinal specialist, whose
clinical practice focuses on major retinal diseases. His research covers epidemiologi-
cal, clinical, and translational studies of eye diseases, including epidemiology and
risk factors of myopia, imaging in myopic macular degeneration, and clinical trials
on treatment of myopic choroidal neovascularization. He has published more than
1000 papers in peer-reviewed journals, including the New England Journal of
Medicine and the Lancet. Prof. Wong has received a number of national and interna-
tional awards.
xi
Introduction and Overview on Myopia: 1
A Clinical Perspective
Chee Wai Wong, Noel Brennan, and Marcus Ang
Key Points
• Myopia is a significant global public health and socioeconomic problem.
• Pathologic myopia has become a major cause of blindness or visual impair-
ment in both Asian and Western populations.
• Myopia may be a highly heritable trait, with environmental influences such
as outdoor activity playing important roles in its development and
progression.
• Control of myopia in children is important, and various strategies includ-
ing pharmacologic and lens-related interventions have proven efficacy.
• Imaging is important to detect complications of pathologic myopia, and both
medical and surgical interventions may be useful for their management.
C. W. Wong · M. Ang (*)
Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
Duke-NUS Medical School, Singapore, Singapore
e-mail: [email protected]
N. Brennan
R&D, Johnson & Johnson Vision Care, Inc, Jacksonville, FL, USA
© The Author(s) 2020 1
M. Ang, T. Y. Wong (eds.), Updates on Myopia,
https://doi.org/10.1007/978-981-13-8491-2_1