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Degenerative Myopia

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Description: Degenerative myopia, also known as pathological myopia, is a severe form of myopia characterized by the progressive elongation of the eyeball, leading to significant vision loss and complications such as retinal detachment, macular degeneration, and glaucoma.
Type: Degenerative myopia, also known as pathological myopia, can have a complex inheritance pattern, often described as multifactorial. This means it involves both genetic and environmental factors. While not attributed to a single gene, studies suggest that several genes may contribute to susceptibility, and the condition may be more common in families with a history of myopia.
Signs And Symptoms: A myopic individual can see clearly out to a certain distance (the far point of the eye), but objects placed beyond this distance appear blurred. If the extent of the myopia is great enough, even standard reading distances can be affected. Upon routine examination of the eyes, the vast majority of myopic eyes appear structurally identical to nonmyopic eyes.Onset is often in school children, with worsening between the ages of 8 and 15.Myopic individuals have larger pupils than far-sighted (hyperopic) and emmetropic individuals, likely due to requiring less accommodation (which results in pupil constriction).
Prognosis: Degenerative myopia, also known as pathological or high myopia, is a severe form of myopia that progresses over time and can lead to several complications affecting vision.

**Prognosis:**
The prognosis for degenerative myopia varies depending on the severity and the presence of complications. Without effective management, it can lead to serious vision problems and potential blindness due to associated conditions such as retinal detachment, myopic macular degeneration, cataracts, and glaucoma. Early diagnosis and regular monitoring are crucial. Treatment options such as corrective lenses, medications, and in some cases, surgical interventions, can help manage symptoms and prevent further deterioration of vision.
Onset: Onset: Degenerative myopia, also known as pathological or progressive myopia, typically begins in childhood or adolescence. It tends to worsen progressively over time, especially during the rapid growth periods of youth.

Nan: The term "nan" is unclear in the context of degenerative myopia. If you meant "nutrition," there is no specific nutritional deficiency directly linked to the development of degenerative myopia. However, a balanced diet rich in vitamins and antioxidants is generally beneficial for overall eye health.
Prevalence: Degenerative myopia, also known as pathologic or progressive myopia, is less common than simple myopia. It affects approximately 0.2% to 3% of the general population, depending on the region and demographic studied. It is more prevalent in East Asian populations.
Epidemiology: Global refractive errors have been estimated to affect 800 million to 2.3 billion. The incidence of myopia within sampled population often varies with age, country, sex, race, ethnicity, occupation, environment, and other factors. Variability in testing and data collection methods makes comparisons of prevalence and progression difficult.The prevalence of myopia has been reported as high as 70–90% in some Asian countries, 30–40% in Europe and the United States, and 10–20% in Africa. Myopia is about twice as common in Jewish people than in people of non-Jewish ethnicity. Myopia is less common in African people and associated diaspora. In Americans between the ages of 12 and 54, myopia has been found to affect African Americans less than Caucasians.
Intractability: Degenerative myopia, also known as pathological myopia, is generally considered intractable, meaning it is not curable. However, the condition can often be managed to some extent with various treatments aimed at slowing its progression and addressing complications. These treatments may include special corrective lenses, medications, and in some cases, surgical interventions to manage associated issues like retinal detachment or choroidal neovascularization. Regular monitoring by an eye care professional is essential to manage the condition effectively.
Disease Severity: Degenerative myopia, also known as pathological myopia, is a severe form of myopia (nearsightedness) that progresses over time and can lead to significant visual impairment. It involves elongation of the eyeball and degeneration of the structures within the eye. Potential complications include retinal detachment, macular degeneration, and glaucoma. The severity can vary widely among individuals, and early diagnosis and management are crucial to slow down the progression and manage complications.
Healthcare Professionals: Disease Ontology ID - DOID:11829
Pathophysiology: Degenerative myopia, also known as pathological myopia, involves progressive elongation of the eyeball (axial lengthening) that leads to thinning and stretching of the retina, choroid, and sclera. This elongation is associated with increased risk of retinal detachment, myopic maculopathy, choroidal neovascularization, and other degenerative changes in the eye's structure.
Carrier Status: Degenerative myopia, also known as pathological myopia, is not typically classified based on carrier status because it is not a simple inherited genetic condition with a clear dominant or recessive inheritance pattern. Instead, it is a complex multifactorial disease influenced by genetic and environmental factors.
Mechanism: Because myopia is a refractive error, the physical cause of myopia is comparable to any optical system that is out of focus. Borish and Duke-Elder classified myopia by these physical causes:
Axial myopia is attributed to an increase in the eye's axial length.
Refractive myopia is attributed to the condition of the refractive elements of the eye. Borish further subclassified refractive myopia:Curvature myopia is attributed to excessive, or increased, curvature of one or more of the refractive surfaces of the eye, especially the cornea. In those with Cohen syndrome, myopia appears to result from high corneal and lenticular power.
Index myopia is attributed to variation in the index of refraction of one or more of the ocular media.As with any optical system experiencing a defocus aberration, the effect can be exaggerated or masked by changing the aperture size. In the case of the eye, a large pupil emphasizes refractive error and a small pupil masks it. This phenomenon can cause a condition in which an individual has a greater difficulty seeing in low-illumination areas, even though there are no symptoms in bright light, such as daylight.Under rare conditions, edema of the ciliary body can cause an anterior displacement of the lens, inducing a myopia shift in refractive error.
Treatment: The National Institutes of Health says there is no known way of preventing myopia, and the use of glasses or contact lenses does not affect its progression, unless the glasses or contact lenses are too strong of a prescription. There is no universally accepted method of preventing myopia and proposed methods need additional study to determine their effectiveness. Optical correction using glasses or contact lenses is the most common treatment; other approaches include orthokeratology, and refractive surgery.: 21–26 Medications (mostly atropine) and vision therapy can be effective in addressing the various forms of pseudomyopia.
Compassionate Use Treatment: For degenerative myopia, compassionate use treatments, off-label, and experimental treatments may include:

1. **Anti-VEGF Therapy**: Originally designed for age-related macular degeneration, anti-VEGF injections (e.g., Ranibizumab or Bevacizumab) are sometimes used off-label to manage complications like myopic choroidal neovascularization.

2. **High-Dose Atropine Eye Drops**: Atropine drops are being researched for myopia control and may have potential as an off-label treatment to slow progression.

3. **Surgical Interventions**: Experimental surgical procedures like posterior scleral reinforcement aim to strengthen the sclera and prevent further elongation of the eye, although these are not yet widely accepted or proven.

4. **Gene Therapy**: Although still in experimental stages, gene therapy might hold future potential for treating degenerative myopia by correcting underlying genetic issues.

5. **Pharmacological Agents**: Various drugs including 7-methylxanthine and certain matrix metalloproteinase inhibitors are under research for their potential to inhibit scleral thinning and myopia progression.

It's important to discuss these options with a healthcare provider to understand potential benefits, risks, and availability in your region.
Lifestyle Recommendations: Lifestyle recommendations for managing degenerative myopia include:

1. **Regular Eye Exams:** Schedule regular check-ups with an eye care professional to monitor the progression of myopia and check for any complications.

2. **Optimal Lighting:** Ensure good lighting when reading or doing close-up work to reduce eye strain.

3. **Breaks from Close Work:** Follow the 20-20-20 rule—every 20 minutes, look at something 20 feet away for at least 20 seconds.

4. **Protective Eyewear:** Wear UV-protective sunglasses when outdoors to protect your eyes from harmful ultraviolet rays.

5. **Healthy Diet:** Consume a balanced diet rich in vitamins A, C, and E, as well as omega-3 fatty acids, to support overall eye health.

6. **Limit Screen Time:** Reduce the amount of time spent on digital devices, and use settings that reduce blue light exposure.

7. **Exercise:** Engage in regular physical activity, which can help improve overall circulation and health, including eye health.

8. **Avoid Smoking:** Smoking can contribute to poor eye health and increase the risk of eye diseases.

9. **Corrective Lenses:** Use prescribed eyeglasses or contact lenses to correct vision and reduce eye strain.

10. **Vision Therapy:** Consult with an eye care professional about vision therapy exercises that may help manage symptoms.
Medication: Anti-muscarinic topical medications in children under 18 years of age may slow the worsening of myopia. These treatments include pirenzepine gel, cyclopentolate eye drops, and atropine eye drops. While these treatments were shown to be effective in slowing the progression of myopia, side effects included light sensitivity and near blur.
Repurposable Drugs: There is no well-established list of repurposable drugs specifically for degenerative myopia at this time. However, common treatments for myopia-related complications may include topical eye drops, such as atropine, which has been used off-label to slow the progression of myopia. Additionally, other treatments like corrective lenses, orthokeratology, and surgical options such as LASIK are used to manage symptoms and correct vision.

As research progresses, it's possible that other drugs may be identified for repurposing. If you are seeking the latest information on this topic, consulting recent clinical studies or an ophthalmologist may provide the most current insights.
Metabolites: For degenerative myopia, often associated with pathologic or progressive myopia, metabolites such as lactate, glucose, and various amino acids may be involved in the condition's metabolic processes. However, comprehensive metabolomic studies specific to degenerative myopia are still limited. It is a complex multifactorial disease influenced by genetic, environmental, and metabolic factors.

If you meant "nan" referring to nanotechnology, advancements in nanomedicine hold potential for treating degenerative myopia. For instance, nanocarriers for targeted drug delivery, gene therapy, or regenerative approaches could offer novel therapeutic strategies, although such applications are still under research and development stages.
Nutraceuticals: Nutraceuticals, which are products derived from food sources with extra health benefits, may help support eye health in individuals with degenerative myopia. Common nutraceuticals involved include:

1. **Lutein and Zeaxanthin**: These carotenoids are known for their role in maintaining eye health and protecting the retina.
2. **Omega-3 Fatty Acids**: Found in fish oil, these can help reduce inflammation and support cell membrane health.
3. **Antioxidants**: Vitamins C and E, selenium, and zinc help combat oxidative stress, which may benefit eye health.
4. **Ginkgo Biloba**: This herbal extract has been studied for its potential to improve blood circulation in the eye.
5. **Bilberry Extract**: Contains anthocyanins that may support retinal function and capillary integrity.

Consulting with a healthcare provider is recommended before starting any new nutraceutical regimen, especially for individuals with specific health conditions like degenerative myopia.
Peptides: Degenerative myopia, also known as pathological myopia, is a severe form of myopia that continues to progress and can lead to additional complications such as retinal detachment, macular degeneration, and glaucoma.

Regarding peptides, research is ongoing to explore their potential use in treating various eye conditions, including degenerative myopia. Peptides may help in modulating biological processes, but their specific role in the treatment of degenerative myopia is not yet well established.

Nanotechnology (nan) is being investigated for its potential applications in ophthalmology, including degenerative myopia. Nanoparticles can be engineered to deliver drugs more effectively to specific sites within the eye, potentially slowing disease progression or improving treatment outcomes. However, clinical applications are still under research and not yet widely available.