High or degenerative myopia is associated to abnormalities of the posterior pole of the eye. Their expansion with time progresses to the occurrence of complications, especially neovascular ingrowth in the central macular area. The natural evolution of these new vessels results in loss of central vision at long term. Photocoagulation of the new vessels, sparing initially the center, has delayed the loss of central vision at 2 years in our randomized clinical trial. Only treated eyes retained useful acuity at 5 years. New therapeutic modalities will be possible when the mechanisms of occurrence of degenerative myopia are elucidated.