High Myopia: Impact on Retina and Visual Perception

Q: High Myopia: Impact on Retina and Visual Perception

Hello： <br>1. <br>Retinal thinning and brightness perception： High myopia can indeed lead to retinal thinning, particularly around the macula. <br>Thinning of the retina may affect the distribution and function of photoreceptor cells, thereby impacting visual quality. <br>The mac

High myopia with enlarged blind spots and retinal degeneration issues?

Hello, Doctor.
I previously inquired about the issues related to high myopia and the expansion of blind spots, and I have a few more questions I would like to ask:
1.
During a previous eye examination, you mentioned that my retina is thinner.
I would like to know if a thinner retina affects the brightness of what I see.
I read that there are more photoreceptor cells in the macula compared to the peripheral vision, which is why normal eyes perceive the center as brighter.
Recently, when I look at a white sheet of paper or a white wall, I vaguely feel that the vision on the side closer to my nose is slightly dimmer (although I can see objects clearly and the range is wide, it just seems a bit darker than the center).
I want to know if high myopia can cause the retina to be stretched thinner, leading to some uneven light perception issues.
2.
Is it true that retinitis pigmentosa typically manifests at an earlier age? I feel that my night vision is still okay, and my visual field seems quite large.
The symptoms I mentioned earlier have been present for a while, and I always thought they were due to retinal degeneration from high myopia.
However, the thought of possibly inheriting retinitis pigmentosa makes me a bit anxious (shivers).
Although I haven't had a visual field test yet, I feel quite anxious about it.
3.
What phenomena can retinal degeneration cause? It seems that it is generally associated with an increased risk of retinal detachment, as you mentioned that a thinner retina can lead to reduced sensitivity of photoreceptors.
I haven't found much information on other effects.
Is it similar to how the retina becomes less effective due to the elongation of the eyeball axis, causing the cells to be spaced further apart and resulting in poorer image quality?
4.
If there is a retinal detachment or a tear, can it be detected through an OCT scan? The clinic I go to frequently performs OCT scans, but dilation isn't done every time.
Sometimes I worry that a retinal tear might be discovered too late.
Thank you, Doctor, for your kind responses.
I understand that many things need to be checked before knowing for sure, but your detailed replies help alleviate the anxiety of patients, which is truly comforting.
Thank you!

O, 40~49 year old female. Ask Date: 2024/08/01

Dr. Gao Pilin reply Ophthalmology

Hello:
1.
Retinal thinning and brightness perception: High myopia can indeed lead to retinal thinning, particularly around the macula.
Thinning of the retina may affect the distribution and function of photoreceptor cells, thereby impacting visual quality.
The macular region is densely populated with photoreceptors and is primarily responsible for central vision and color perception; thus, it is normal to perceive brightness in the center.
If the vision slightly dims on the side closer to the nose, this may be related to retinal thinning or other distributions of photoreceptor cells, but further examination is needed to determine the specific cause.
2.
Retinitis pigmentosa: This condition typically manifests at a younger age, although there are exceptions.
Early symptoms include night blindness and peripheral vision loss.
The symptoms you describe may be related to retinal degeneration caused by high myopia, but to rule out retinitis pigmentosa, a comprehensive visual field test and genetic testing are recommended.
If there is a family history of the condition, early examination is even more important.
3.
Retinal degeneration phenomena: Common manifestations of retinal degeneration include retinal thinning and decreased photoreceptor function, leading to blurred vision and visual field defects.
In patients with high myopia, the retina is stretched, and the distribution of cells becomes sparse, which may affect visual quality.
Retinal degeneration also increases the risk of retinal detachment, necessitating regular examinations for prevention.
4.
OCT examination of the retina: Optical coherence tomography (OCT) allows for detailed observation of the retinal structure and can detect issues such as retinal thinning, detachment, and holes.
However, the scope of OCT is limited and cannot fully replace dilated fundus examination.
Therefore, for patients at risk of high myopia or retinal degeneration, regular dilated examinations are recommended to ensure a comprehensive understanding of retinal health.
Your concerns are understandable, and it is advisable to seek an ophthalmological examination as soon as possible to further determine the cause and receive appropriate treatment.
Wishing you a speedy recovery!

Reply Date: 2024/08/01

More Info

High myopia, or severe nearsightedness, is a condition that can significantly impact the structure and function of the eye, particularly the retina. As you have raised several important questions regarding the implications of high myopia on visual perception and retinal health, let’s delve into each of your concerns.

1. Impact of Thinning Retina on Brightness Perception: A thinner retina, particularly in individuals with high myopia, can indeed affect visual perception, including brightness. The macula, which is the central part of the retina responsible for sharp vision, contains a high concentration of photoreceptor cells (cones) that are sensitive to light. In contrast, the peripheral retina has fewer photoreceptors. Therefore, it is normal for the central vision to appear brighter than peripheral vision. If your retina is thinner, particularly in the peripheral regions, it may lead to uneven light perception, causing areas of your vision to seem darker or less vibrant. This could explain your observation of reduced brightness near your nose while still maintaining clarity in your peripheral vision.

2. Age of Onset for Retinal Diseases: Retinitis pigmentosa, a type of pigmentary retinal degeneration, typically manifests in early adulthood or even childhood. However, the onset can vary widely among individuals. While you may feel that your night vision is adequate, it is essential to monitor any changes in your visual field or perception. Genetic factors play a significant role in conditions like retinitis pigmentosa, and if there is a family history, it may warrant further investigation. Anxiety about potential hereditary conditions is understandable, but it is crucial to focus on regular eye examinations and monitoring.

3. Symptoms of Retinal Degeneration: Retinal degeneration, particularly in the context of high myopia, can lead to several symptoms. These may include increased susceptibility to retinal detachment, which is a serious condition that can lead to vision loss. As the eye elongates in high myopia, the retina can become stretched and thinner, potentially leading to a decrease in the sensitivity of photoreceptors. This can manifest as blurriness, particularly in low-light conditions, or difficulty in seeing fine details. Additionally, patients may experience visual distortions, such as wavy lines or shadows, due to the structural changes in the retina.

4. Detection of Retinal Detachment or Holes via OCT: Optical coherence tomography (OCT) is a non-invasive imaging technique that provides high-resolution images of the retina. It is effective in detecting retinal detachments and holes. If there is a significant concern about retinal integrity, OCT can reveal abnormalities such as thinning, detachment, or the presence of fluid beneath the retina. Regular OCT scans, especially for high myopia patients, are crucial for early detection of potential complications.

In summary, high myopia can lead to various changes in the retina that may affect visual perception, including brightness and clarity. Regular eye examinations, including OCT imaging, are essential for monitoring retinal health and addressing any emerging symptoms. If you experience any new or worsening symptoms, it is vital to consult with your eye care professional promptly. Your proactive approach to understanding your condition and seeking clarification is commendable, and it is essential to continue this dialogue with your healthcare provider to ensure optimal eye health.

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