One of the main causes of vision loss that affects people of all ages worldwide is myopia. Pathologic myopia is characterized by “High Myopia” (spherical equivalent > -6 diopters, or axial length >26.5 millimeters) and progressive anatomical degenerations of the ocular posterior segment (sclera, choroid and retina). Consequently, posterior staphyloma, degenerative myopic maculopathy (DMM) with eventual choroidal neovascularization (CNV), and myopic traction maculopathy (MTM) may possibly develop. Moreover, severe myopia that occurs in childhood can cause serious vision impairment, including ametropic amblyopia. Notably, for each of these clinical situations, pharmacological and surgical approaches have been proposed. So far, non-invasive management and prevention of pathologic myopia still represent a challenge. This Research Topic attempts to shed light on the current status-of-the-art of pharmacological therapy for pathologic myopia.

Pharmacological interventions from an early age may avoid or slow the development of pathologic myopia, hence lowering the onset of amblyopia and degenerative anatomic changes. Interestingly, atropine at different concentrations (high, moderate and low-doses), pirenzepine and 7-methyxanthine may be a substitute for other treatments in pediatric patients, including multifocal soft or rigid-gas permeable or corneal reshaping (orthokeratology) contact lenses, peripheral defocus, or multifocal spectacle lenses. Nowadays, several anti-vascular endothelial growth factors (VEGF) drugs (bevacizumab, ranibizumab, aflibercept) have been introduced in treatment of CNV secondary to DMM, with encouraging results. Finally, the most difficult task would be to discover a pharmacological treatment for the different MTM scenarios, where vitreoretinal surgery is currently recommended as the gold-standard therapy. In these conditions, intravitreal ocriplasmin could be an alternative option.

Authors are encouraged to discuss state-of-the-art or their clinical experience in pharmacological management of pathological myopia. Specifically, the following categories of articles will be accepted (ranked by significance): research articles, reviews, case series/reports (only for rare cases). Notably, Authors are expected to elucidate these issues:

• Evaluation of currently available pharmacological treatment schemes, with emphasis on the exploration of new treatment modalities for children and adults
• The effectiveness of drug treatments for childhood myopia, including research on the effective dosage of atropine, as well as the search for similar pharmacological substitutes
• Research on the feasibility of preventing or slowing down DMM through drugs. In the context of CNV secondary to DMM, exploration of multimodal imaging and functional biomarkers associated with anti-VEGF efficacy
• Active exploration of the therapeutic prospects of ocriplasmin, especially in alleviating pathological tractions in MTM. Research on the sensitivity of specific MTM subtypes to ocriplasmin intervention
• Investigation of strategies that combine pharmacological treatment with other treatments such as contact lenses and light therapy

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Frontiers in Medicine

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