High myopia, defined as refractive error of at least −6.00D or an axial length of 26.5 mm or more, can induce many modifications in eye’s anatomy that can lead to complications. When high myopia is able to decrease best corrected visual acuity (BCVA) due to its complications, it is called pathologic myopia. Pathologic myopia is one of the major causes of blindness, and it represents a serious issue, since incidence of myopia and high myopia is constantly rising. For educational purposes, in this chapter, complications of pathologic myopia will be divided into anterior (when structures external to the globe or anterior to the ora serrata are involved, such as motility disturbances and cataract) and posterior (when structures posterior to the ora serrata are involved, such as lacquer cracks, chorioretinal atrophy, Fuchs maculopathy, myopic choroidal neovascularization, and retinal detachment). Many treatments are available for pathologic myopia complications depending on their type, such as vascular endothelial growth factor (anti-VEGF) injections and surgery. We will focus on visual rehabilitation interventions, such as visual biofeedback and visual aids that in many cases are the only chance that the ophthalmologist has in order to help patients suffering from pathologic myopia to use at their maximum their residual vision.
Part of the book: Intraocular Lens
The chapter examines the use of stem cells in ophthalmological pathologies affecting both the anterior and posterior segments. The authors review the clinical trials that have most contributed to defining the role and potential of stem cell regenerative therapy in corneal and retinal pathology. The results described in the scientific literature are analyzed and commented, without neglecting the possible side effects related to the use of this therapy. Within the anterior segment, the greatest efforts were made to study the possible uses of limbal epithelial stem cells (LESCs). They were the first stem cells to be discovered at the level of the anterior segment and currently the only ones involved in clinical practice with satisfactory results. At this juncture there have been significant successes in the treatment of corneal stem cell deficiency and of corneal scars. The chapter later investigates the possible applications of stem cell therapy in degenerative retinal diseases, with particular reference to retinitis pigmentosa, Stargardt’s disease, and age-related macular degeneration. It then describes how the use of cell therapies, in particular those that use ADSC, can contribute, through various methods, to the containment of the evolution of retinal degenerative diseases. These mechanisms cover various biological aspects and can be summarized as follows: neurotrophism, oxidation, vascular changes, apoptosis, inflammation, or immunology. The ophthalmological modalities of the cell graft and what is the ideal approach for an ophthalmological cellular surgery are later on described. Finally, the technique used by the author and the possible outcomes in the course of degenerative retinopathy are described.
Part of the book: Regenerative Medicine