AOA 2025: A review of myopic retinal complications with Dr Carolyn Majcher

Carolyn Majcher, a professor and director of residency programs at the Oklahoma College of Optometry, presented a collaborative discussion with her colleague Mary Beth Yackey about retinal complications associated with high myopia. Their presentation focused on the critical importance of understanding and managing potential vision-threatening conditions in patients with significant myopic refractive errors. The presentation comprehensively explored several key retinal complications commonly observed in high myopia patients. These include retinal tears, rhegmatogenous retinal detachment, foveal schisis (myopic traction maculopathy), and myopic choroidal neovascularization. Despite neither presenter personally practicing myopia management, they strongly emphasized its potential to prevent serious retinal and glaucomatous complications.

A significant portion of the discussion centered on the critical role of multi-modal imaging in monitoring and managing these conditions. Majcher highlighted the importance of using advanced diagnostic technologies like ultra-wide field imaging to detect retinal breaks or tears that might require prophylactic barrier laser treatment. Additionally, optical coherence tomography (OCT) and OCT angiography were recommended for identifying and tracking choroidal neovascularization, particularly in monitoring treatment response to anti-VEGF therapy. Patient education emerged as a crucial component of managing high myopia-related risks.

Majcher stressed the need to educate patients about their increased vulnerability to retinal complications. She recommended providing patients with Amsler grids to help them self-monitor for early signs of macular changes and teaching them to recognize symptoms of retinal detachment and tears.

The presentation underscored the importance of proactive management and early intervention. By educating patients, utilizing advanced imaging technologies, and maintaining vigilant monitoring, eye care professionals can potentially mitigate the risk of severe vision-threatening complications associated with high myopia. The key takeaways included the critical nature of myopia management, the value of multi-modal imaging, the significance of patient education, and the need for timely referrals to retinal specialists when complex complications are detected.