Myopic Choroidal Neovascularization: Review, Guidance, and Consensus Statement on Management.

Cheung, Chui Ming Gemmy; Arnold, Jennifer J; Holz, Frank G; Park, Kyu Hyung; Lai, Timothy Y Y; Larsen, Michael; Mitchell, Paul; Ohno-Matsui, Kyoko; Chen, Shih-Jen; Wolf, Sebastian; Wong, Tien Yin (2017). Myopic Choroidal Neovascularization: Review, Guidance, and Consensus Statement on Management. Ophthalmology, 124(11), pp. 1690-1711. Elsevier 10.1016/j.ophtha.2017.04.028

Text 1-s2.0-S0161642017313015-main.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (1MB)

TOPIC

The aim of this article is to review and compile available information on the classification, pathophysiology, and clinical features of myopic choroidal neovascularization (CNV); to describe the latest data on the management of this disease; and to present guidance.

CLINICAL RELEVANCE

In the United States, myopia affects approximately 34 million people (2010), and similar figures have been reported in Europe. Pathologic myopia (PM), a possible consequence of myopia, is estimated to affect up to 3% of the global population. One of the most serious complications of PM is myopic CNV, which often leads to a sudden onset but progressive decline in central vision and is associated with a poor prognosis unless treated. Furthermore, 35% of patients with myopic CNV develop bilateral disease in the fellow eye within 8 years. Although intravitreal anti-vascular endothelial growth factor (VEGF) therapies have had a major impact on the management of patients with myopic CNV, there remain significant gaps in our understanding of this condition and how to best administer treatment. Additionally, the long-term safety and efficacy of these treatments are largely unknown.

METHODS

We carried out a literature review (September 2015) of all English-language articles in PubMed resulting from searches of the following terms: "choroidal neovascularization" AND "myopia" OR "myopic macular degeneration" OR "degenerative myopia" OR "myopic maculopathy" OR "myopic retinopathy" OR "pathological myopia" OR "pathologic myopia."

RESULTS

We screened a total of 566 abstracts, and 250 articles were deemed relevant for full publication review. We excluded a further 71, but an additional 44 articles were identified. This resulted in 223 articles being used to develop this review.

CONCLUSIONS

Highly myopic patients experiencing a sudden loss of central vision should be referred for further examination. Once a diagnosis of myopic CNV has been confirmed, after fluorescein angiography, treatment initiation should be prompt and anti-VEGF agents considered as first-line therapy, unless contraindicated. Continued monitoring of patients is required to assess any progression or recurrence of the condition.

Interest & Impact

Downloads

2 since deposited on 10 Oct 2017
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item