The goal of this review is to summarize structural and anatomical changes associated with high myopia. Axial elongation in myopic eyes is associated with retinal thinning and a reduced density of retinal pigment epithelium (RPE) cells in the equatorial region. Thickness of the retina and choriocapillaris and RPE cell density in the macula are independent of axial length. Choroidal and scleral thickness decrease with longer axial length in the posterior hemisphere of the eye, most marked at the posterior pole. In any eye region, thickness of Bruch’s membrane (BM) is independent of axial length. BM opening, as the inner layer of the optic nerve head layers, is shifted in temporal direction in moderately elongated eyes (axial length <26.5 mm). It leads to an overhanging of BM into the intrapapillary compartment at the nasal optic disc side, and to an absence of BM at the temporal disc border. The lack of BM at the temporal disc side is the histological equivalent of parapapillary gamma zone. Gamma zone is defined as the parapapillary region without BM. In highly myopic eyes (axial length >26.5 mm), BM opening enlarges with longer axial length. It leads to a circular gamma zone. In a parallel manner, the peripapillary scleral flange and the lamina cribrosa get longer and thinner with longer axial length in highly myopic eyes. The elongated peripapillary scleral flange forms the equivalent of parapapillary delta zone, and the elongated lamina cribrosa is the equivalent of the myopic secondary macrodisc. The prevalence of BM defects in the macular region increases with longer axial length in highly myopic eyes. Scleral staphylomas are characterized by marked scleral thinning and spatially correlated BM defects, while thickness and density of the choriocapillaris, RPE and BM do not differ markedly between staphylomatous versus non-staphylomatous eyes in the respective regions. High axial myopia is associated with a thinning of the sclera and choroid posteriorly and thinning of the retina and RPE density in the equatorial region, while BM thickness is independent of axial length. The histological changes may point towards BM having a role in the process of axial elongation.

中文翻译：

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高度近视眼近视研究解剖学发现的进展。

本综述的目的是总结与高度近视相关的结构和解剖学变化。近视眼的眼轴伸长与赤道区域视网膜变薄和视网膜色素上皮（RPE）细胞密度降低有关。视网膜和脉络膜毛细血管的厚度以及黄斑中的 RPE 细胞密度与眼轴长度无关。眼睛后半球的脉络膜和巩膜厚度随着眼轴长度的增加而减小，在后极处最为明显。在任何眼睛区域，布鲁赫膜（BM）的厚度与眼轴长度无关。BM 开口作为视神经乳头层的内层，在中等伸长的眼睛（眼轴长度<26.5 毫米）中沿颞方向移动。它导致 BM 悬垂到鼻视盘侧的乳头内隔室中，并且导致颞盘边界处 BM 缺失。颞盘侧缺乏 BM 相当于视乳头旁伽玛区的组织学。伽玛区定义为没有 BM 的乳头旁区域。在高度近视眼（眼轴>26.5毫米）中，眼轴越长，BM开口越大。它通向圆形伽玛区。以平行的方式，高度近视眼的视乳头周围巩膜凸缘和筛板变得更长更薄，眼轴也更长。拉长的视乳头周围巩膜凸缘形成相当于视乳头旁三角区，而拉长的筛板相当于近视的次级大盘。高度近视眼中，黄斑区 BM 缺陷的发生率随着眼轴的延长而增加。巩膜葡萄肿的特点是巩膜明显变薄和空间相关的 BM 缺陷，而葡萄肿眼与非葡萄肿眼各区域的脉络膜毛细血管、RPE 和 BM 的厚度和密度没有显着差异。高度轴性近视与巩膜和脉络膜后部变薄以及视网膜变薄和赤道区域的 RPE 密度相关，而 BM 厚度与眼轴长度无关。组织学变化可能表明 BM 在轴向伸长过程中发挥作用。