Overview of OCT-Based Classification of Macular Lesions Due to Pathologic Myopia

Optical coherence tomography (OCT) has become an indispensable tool in the diagnosis and management of various lesions associated with pathologic myopia. Although META-PM classification is very useful, the diagnosis of diffuse atrophy relies solely on its yellowish appearance on ophthalmoscopy which may look different according to the degree of fundus pigmentation. Each lesion of myopic maculopathy should be analyzed using OCT. Progressive choroidal thinning was found from tessellated fundus to peripapillary diffuse choroidal atrophy and to macular diffuse choroidal atrophy. Patchy atrophy and myopic choroidal neovascularization-related macular atrophy were not simply an atrophy but were macular Bruch’s membrane defect. Other macular lesions, such as myopic traction maculopathy and dome-shaped macula, that could not be detected by fundus photographs were revealed by OCT. Based on OCT features of each lesion of myopic maculopathy, OCT-based classification is presented in this chapter.