What is Myopic Macular Degeneration (MMD)?
Myopia is a common eye condition where distant objects appear blurry. Myopic eyes are longer than they should be. When the eye is too long, there could be biological and mechanical changes to the layers at the back of the eye. This condition is often referred to as degenerative or pathological myopia. When the changes involve the macula, it is often called myopic macular degeneration (MMD) or myopic maculopathy.
Prevalence of MMD
Over 40 million people around the world currently suffer from MMD.
In Japan, MMD alone has been found to cause 12.2% of visual impairments. (approximately 200,000 people).
More than 1,000,000 people suffer from MMD in the USA alone.
Projected figures: By 2050, it is estimated that there will be 1 billion high myopes in the world, at least 10% of whom (or 100,000,000) will develop MMD.
PREVALENCE OF HIGH MYOPIA IN YOUNG ADULTS
Treatment of MMD
There is currently no treatment for dry MMD, which accounts for 90% of all cases.
The most common treatment for wet MMD is an injection in the eye of an anti-VEGF drug, which makes the abnormal blood vessels shrink. Some common commercial names for these medications are Avastin, Lucentis, and Eylea. Other treatments, such as laser or photodynamic therapy, are available, but they are less commonly used. Some patients need only one or a few injections to control wet MMD, while others may need more frequent treatment. Wet MMD needs to be treated quickly (ideally within a few days of the bleed) to ensure the best possible visual recovery.
Video intended for optometry students, with numerous technical terms and pictures of the retina: What is myopic degeneration?
Pr. Coffey, UCL, videoconference: Myopic macular degeneration and how to find a cure
Pr. Jeremy Guggenheim, Cardiff University, videoconference on Myopic Macular Disease
Living well with MMD
Downloadable and printable Amsler grid in PDF format: AMSLER Grid (PDF)
College of Optometrists, video tutorial: What is the AMSLER grid, and how to use it to check you vision?
American Academy of Ophthalmology, video tutorial: How to Use the Amsler Grid to Check Your Vision (video)
University of Michigan, Kellogg Eye Center, basic information on MMD along with Amsler grid in PDF format: Myopic Degeneration
An interview with a young MMD patient: Living with Myopic Macular Degeneration - Theresa Mabe
MMD Patient Advocate and Blogger Andrea Junge: Macular Degeneration
Video interview with Dr Bonnielin Swenor, MMD patient and low vision researcher: Diagnosis of Myopic Macular Degeneration with Dr. Bonnielin Swenor
MMD Patient Podcast: https://www.facebook.com/insensitivebymarci/
Medical and Research articles on myopia and MMD
Please note: Some of these links lead to scientific papers in research journals. Depending on where you live, you may not have access to the full texts. You can always email the corresponding author of the paper to ask for the full text.
Erik K. Chin, David RP Almeida, Myopia Awareness and the Evolving Myopigenic Landscape (2021)
Kyoko Ohno-Matsui, Pathologic Myopia 2021, Springer 2020 (medical textbook)
American Academy of Ophthalmology: Diagnosis and Treatment of CNV in Myopic Macular Degeneration
P.N. Baird, et al. Myopia, Nature reviews disease primers, 99 (2020)
Ruiz-Medrano, et al. Myopic maculopathy: Current status and proposal for a new classification and grading system (ATN), Progress in Retinal and Eye Research, 80, 69 (2019)
Wu, Pei-Chang et al. Epidemiology of Myopia, 6, 386 (2016)
Silva R. Myopic maculopathy: A review, Ophthalmologica. 2012; 228: 197-213.
Wong TY, Ferreira A, Hughes R, et al. Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: An evidence-based systematic review. Am J Ophthalmol. 2014; 157(1): 9-25.
Young TL. The molecular genetics of human myopia: An update, Optom Vis Sci. 2009; 86(1): E8-E22.
Additional sources of information
Pathological Myopia (website, US)
Fighting Blindness (website, IR)
Myopic macular degeneration and how to find a cure (videoconference recording)
International Myopia Institute (website, Australia)
Myopia education and prevention in children, Brien Holden Vision Institute (website, Australia)
Potential Future Treatments
Please note: These videos discuss cell replacement therapies that are currently being studied. Some are still in the laboratory, while others are in animal and human studies. None of these potential therapies is available yet; they are experimental. Most of these videos mention cell replacement therapies for other retinal diseases, like age-related macular degeneration, or inherited retinal diseases.
Dr Stanley Chang, Columbia University, and Dr Kapil Bharti, National Eye Institute, with the New York Stem Cell Foundation, Restoring Vision with Stem Cells
Dr Brian Ballios with Fighting Blindness Canada Stem Cells and Ocular Regenerative Medicine
Dr Davis Gamm with Fighting Blindness Canada (including photoreceptor replacement) Restoring Vision with Stem Cells Dr David Gamm - YouTube