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

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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.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Wolf, Sebastian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0161-6420

Publisher:

Elsevier

Language:

English

Submitter:

Sebastian Wolf

Date Deposited:

10 Oct 2017 08:03

Last Modified:

24 Oct 2017 01:31

Publisher DOI:

10.1016/j.ophtha.2017.04.028

PubMed ID:

28655539

BORIS DOI:

10.7892/boris.101686

URI:

https://boris.unibe.ch/id/eprint/101686

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