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Der Ophthalmologe

, Volume 116, Issue 6, pp 499–508 | Cite as

Epidemiologie und Anatomie der Myopie

  • Jost B. JonasEmail author
  • Songhomitra Panda-Jonas
Leitthema
  • 358 Downloads

Zusammenfassung

Hintergrund

Die Myopie nimmt weltweit, insbesondere in Ost- und Südostasien, in ihrer Häufigkeit zu.

Ziel der Arbeit

Das Ziel der Arbeit ist die Darstellung der Epidemiologie der Myopie und der Myopie-assoziierten morphologischen Veränderungen.

Material und Methoden

Die Ergebnisse von epidemiologischen, klinischen und histologischen Studien werden zusammenfassend beschrieben.

Ergebnisse

In den letzten 3 Dekaden hat die Prävalenz der Myopie ausgeprägt zugenommen, sodass zurzeit ca. 80–90 % der 18-Jährigen in Ostasien myop und 10–20 % hoch myop sind. Man schätzt, dass im Jahr 2050 die Häufigkeit der Myopie auf 50 % und die der hohen Myopie auf ca. 10 % weltweit ansteigen wird und dass die hohe Myopie wegen der damit verbundenen myopischen Makulopathie und glaukomatösen Optikusatrophie zur häufigsten Ursache für irreversible Erblindung werden kann. Morphologisch ist die Myopie gekennzeichnet durch eine vornehmlich sagittale und zu geringem Anteil koronare Bulbusvergrößerung, Verdünnung der Netzhaut und retinalen Pigmentepithelzelldichte im Äquatorbereich, Verdünnung der Choroidea und Sklera vornehmlich am hinteren Pol, unveränderte Dicke der Bruch-Membran insgesamt und der Retina im Makulagebiet, unveränderte Dichte der retinalen Pigmentepithelzelldichte im Makulabereich, vergrößerte Papillen-Fovea-Entfernung durch die sich bildenden parapapillären Gamma- und Deltazonen und vertikale Rotation und Vergrößerung der Papille mit Verlängerung und Verdünnung der Lamina cribrosa und des peripapillären Skleralstegs.

Diskussion

Diese morphologischen Veränderungen lassen sich möglicherweise durch eine Neubildung und Verlängerung der Bruch-Membran im Äquatorbereich als Ursache für die sagittale Bulbusverlängerung erklären.

Schlüsselwörter

Hohe Myopie Myopische Makulopathie Myopische Retinopathie Bruch-Membran Glaukom 

Epidemiology and anatomy of myopia

Abstract

Background

The prevalence of myopia has markedly increased, particularly in the young generations in East and Southeast Asia.

Objective

The aim is to describe the epidemiology of myopia and the morphological alterations associated with myopia.

Material and methods

The results of epidemiological, clinical and histological studies are summarized.

Results

During the last three decades the prevalence of myopia has markedly increased so that currently 80–90% of 18-years-olds in East Asia are myopic and 10–20% are highly myopic. It is estimated that by 2050 the frequency of myopia worldwide will increase to 50% and high myopia to ca. 10% and high myopia will become the most frequent cause of irreversible blindness due to the association with myopic maculopathy and glaucomatous optic nerve atrophy. Myopia is morphologically characterized by predominantly sagittal and to a lesser extent coronal enlargement of the eyeball. This results in retinal thinning and reduction in the density of the retinal pigment epithelium (RPE) in the equatorial region, thinning of the choroid and sclera mostly at the posterior pole, normal retinal thickness and RPE density in the macular region, normal thickness of Bruch’s membrane (BM) in any region, elongated disc-fovea distance due to the development of parapapillary gamma and delta zones, enlargement and vertical rotation of the optic disc and elongation and thinning of the lamina cribrosa and peripapillary scleral flange.

Discussion

These morphological alterations can possibly be explained by a new formation and elongation of the BM in the equatorial region leading to sagittal elongation of the eyeball.

Keywords

High myopia Myopic maculopathy Myopic retinopathy Bruch’s membrane Glaucoma 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

J.B. Jonas und S. Panda-Jonas sind Patentinhaber zusammen mit Biocompatibles UK Ltd. (Franham, Surrey, UK) (Titel: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or anti-angiogenic factor; Patent number: 20120263794); und Patentanmeldung (Titel: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Europäische Patentanmeldung 15 000 771.4).

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Privatpraxis JonasHeidelbergDeutschland
  2. 2.Lehrstuhl für Ophthalmologie, Medizinische Fakultät MannheimRuprecht-Karls-Universität HeidelbergHeidelbergDeutschland

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