Clinical characteristics of patients with congenital high myopia

Four cases of congenital high myopia showing similar myopic fundus changes.

The clinical characteristics of four cases of congenital high myopia are presented, and the long-term course of one of these cases is described.

One patient had a history of preterm delivery; however, the remaining patients had no ocular or systemic abnormalities that could account for the congenital myopia. All of the cases showed similar fundus findings, including tilting of the optic disc, temporal conus, and tessellated fundus. A type II posterior staphyloma was found in three of the cases. All of the patients had best-corrected visual acuity (BCVA) ≥ 0.4. One patient was followed for 30 years (from 6 to 36 years of age), and during those 30 years, the posterior fundus showed only a slight enlargement of a myopic conus and slight increase of the tilting of the optic disc despite a 3.0-mm increase in the axial length, and final BCVA was 1.0 OU.

Long-term follow-up showed that the posterior fundus did not change radically and good vision as maintained in spite of a significant increase in the axial length.