Diffuse choroidal retinal atrophy (DCA) is a type of myopic macular disease that presents with yellowish-white atrophic changes at the posterior pole of the eyeball. DCA is an important critical feature in the diagnosis of pathological myopia. Early intervention and treatment of this disease are of great significance in delaying the progression of pathological myopia and reducing the impairment of visual function. Ophthalmic imaging data can be used to diagnose the disease, and color fundus photography is the most simple and intuitive. Choroidal thickness is also a key indicator in the diagnosis of DCA, but the diagnostic critical value of choroidal thickness has not been clearly defined. With the development and popularization of artificial intelligence technology, the analysis of lesion imaging data is more objective and accurate. In the future, it is expected to actively establish a standard quantitative evaluation system for DCA by means of artificial intelligence to achieve early detection, early diagnosis and early treatment of pathological myopia.
Pathologic myopia-associated macular neovascularization (MMN) is a prevalent clinical ophthalmic condition characterized by pathological changes including lacquer cracks, choroidal neovascularization, and Fuchs spots. Recent advancements in fundus imaging technologies and diagnostic equipment have provided novel perspectives and strategies for the diagnosis, staging, treatment, and follow-up of MMN. The continuous development of various anti-vascular endothelial growth factor agents has effectively preserved visual acuity in pathologic myopia-associated macular neovascularization patients. However, in the clinical practice of MMN, there are still many challenges, such as the lack of unified disease definitions and staging criteria, differences in the criteria for assessing disease activity, the absence of standardized treatment protocols, and the urgent need for optimized follow-up strategies. To address these issues, Fundus Disease Group of Ophthalmological Society of Chinese Medical Association and Fundus Disease Group of Ophthalmologist Branch of Chinese Medical Doctor Association jointly developed the Expert consensus on standardized diagnosis and treatment of pathologic myopia-associated macular neovascularization in China based on the principles of evidence-based medicine. This consensus systematically outlines the core elements of MMN diagnosis and treatment, including disease definitions and clinical staging criteria, identification of high-risk factors, diagnostic procedures, follow-up management protocols, assessment of disease activity, selection of individualized treatment strategies, criteria for re-treatment, and long-term follow-up strategies. It provides ophthalmologists at all levels with a scientifically standardized and clinically applicable guide. The consensus particularly emphasizes the implementation of precision medicine in clinical practice, and stresses that individualized treatment decisions should be made within the framework of standardized care, taking into account the patient’s visual needs, lesion characteristics, treatment response, and socioeconomic factors.
Pathological myopic tractional maculopathy (MTM), as an important type of macular lesions associated with high myopia, play a significant role in the prevention and treatment of myopic macular diseases. With the rapid development of retinal imaging technologies, especially the widespread application of optical coherence tomography, new technical support has been provided for the accurate diagnosis, clinical staging, treatment decision-making, and long-term follow-up of MTM. However, in clinical practice in China, there are still issues such as unclear definitions, inconsistent staging criteria, and significant differences in treatment strategies. To address these challenges, Fundus Diseases Group in Ophthalmology Branch of Chinese Medical Association and Professional Committee of Fundus Diseases in Ophthalmology Branch of Chinese Medical Doctor Association for Ophthalmologists jointly drafted the Expert consensus on management of pathologic myopic tractional maculopathy in China, based on a systematic literature review and the latest clinical evidence. The consensus was revised multiple times by the core expert group and finally finalized. This consensus systematically establishes a standardized diagnostic and therapeutic system for MTM, covering disease definition and staging, diagnostic pathways and follow-up protocols, treatment strategies based on staging, and surgical intervention plans. It aims to provide ophthalmologists at all levels with a scientifically sound and practically applicable clinical guidance. The development of the consensus strictly adheres to the principles of evidence-based medicine, fully considering the actual clinical conditions of medical institutions at different levels in China. It provides principled recommendations with broad guiding significance for the clinical practice of MTM. It is particularly emphasized that when applying this consensus, clinicians should comprehensively consider the patient’s clinical characteristics, treatment accessibility, and socioeconomic factors, and implement personalized and precise treatment strategies to meet the diverse clinical needs of patients with pathological myopia.