Diagnosis – sub-clinical mini-bulges secondary to myopia
Treatment – Since some authorities believe that IOPs can result in posterior staphyloma in patients with genetic weak elements of the sclera, diurnal IOPs are advisable. Treatment of patients with high IOPs or spikes in IOPs should be considered to prevent loss of the retinal nerve fiber layer (RNFL) and of the photoreceptor layer. The RNFL can be monitored with GDx VCC or OCT – available at http://www.lulu.com. The photoreceptors can be monitored with SD OCT and analysis of the Photoreceptor lntegrity Line. The PIL is a subject of the new book: Photoreceptor Integrity Line as Revealed by Spectral Domain OCT – available at http://www.lulu.com.
Some advocate scleral buckling procedures in progressing cases to reinforce the weakened sclera with some preliminary success as reported at the International Myopia Conference in Singapore in August of 2006. Atropine has worked to slow the progression of myopia in several reported studies.
Some advocate nutritional assessment, others various forms of vision training and still others drugs such as 7-methylxanthine. Unfortunately, most of these patients continue to progress but perhaps early detection of mini bulges someday will lead to early intervention and stabilization.