Chui Ming Gemmy Cheung1, Jennifer J Arnold2, Frank G Holz3, Kyu Hyung Park4, Timothy Y Y Lai5, Michael Larsen6, Paul Mitchell7, Kyoko Ohno-Matsui8, Shih-Jen Chen9, Sebastian Wolf10, Tien Yin Wong11. 1. Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, National University of Singapore, Singapore. 2. Marsden Eye Specialists, Parramatta, Australia. 3. Department of Ophthalmology, University of Bonn, Bonn, Germany. 4. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 5. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China. 6. Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 7. University of Sydney, Sydney, Australia. 8. Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan. 9. Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan. 10. Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland. 11. Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, National University of Singapore, Singapore. Electronic address: tien_yin_wong@nuhs.edu.sg.
Abstract
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.
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.
Authors: Yong Li; Feihui Zheng; Li Lian Foo; Qiu Ying Wong; Daniel Ting; Quan V Hoang; Rachel Chong; Marcus Ang; Chee Wai Wong Journal: Diagnostics (Basel) Date: 2022-06-08
Authors: Peter M Maloca; Emily A Williams; Faisal Mushtaq; Andreas Rueppel; Philipp L Müller; Clemens Lange; Emanuel R de Carvalho; Nadja Inglin; Michael Reich; Catherine Egan; Pascal W Hasler; Adnan Tufail; Hendrik P N Scholl; Philippe C Cattin Journal: Acta Ophthalmol Date: 2021-05-14 Impact factor: 3.988