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ICON-PM: International Consensus on Nomenclature for Adult Pathologic Myopia
Richard F Spaide1, Anita Agarwal2, Shih-Jen Chen3
1Vitreous, Retina, Macula Consultants of New York.
Progress in Retinal and Eye Research
|July 20, 2026
Summary
A new international consensus provides standardized imaging-based terminology for adult pathologic myopia using optical coherence tomography (OCT). This framework defines six domains to improve classification and guide future research in myopia.
Area of Science:
- Ophthalmology
- Medical Imaging
- Pathology
Background:
- Pathologic myopia presents complex structural changes.
- Current terminology lacks standardization, hindering research and clinical practice.
Purpose of the Study:
- To establish an international consensus on terminology for adult pathologic myopia.
- To emphasize contemporary imaging, particularly optical coherence tomography (OCT).
Main Methods:
- Convened an international panel of 32 experts in myopia and retinal diseases.
- Utilized a Delphi process with anonymous voting and iterative revision.
- Reviewed existing classifications and literature to develop consensus statements.
Main Results:
- Developed 44 consensus statements with high agreement (mean 90.9%).
- Created a framework emphasizing structural definitions from OCT and multimodal imaging.
- Organized pathologic myopia manifestations into six distinct anatomical and biomechanical domains.
Conclusions:
- Established a unified, imaging-based lexicon for adult pathologic myopia.
- The framework enhances clarity, reproducibility, and provides a basis for future studies.
- Defines entities using OCT, reducing ambiguity in classification systems and trials.
