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Myopic choroidal neovascularisation: current concepts and update on clinical management.

ABSTRACT: Choroidal neovascularisation (CNV) is a common vision-threatening complication of myopia and pathological myopia. Despite significant advances in understanding the epidemiology, pathogenesis and natural history of myopic CNV, there is no standard definition of myopic CNV and its relationship to axial length and other myopic degenerative changes. Several treatments are available to ophthalmologists, but with the advent of new therapies there is a need for further consensus and clinical management recommendations. Verteporfin photodynamic therapy has been an established treatment for subfoveal myopic CNV for many years, but this treatment does not restore visual acuity and is associated with long-term chorioretinal atrophy. More recently, clinical trials investigating the efficacy and safety of anti-vascular endothelial growth factor agents in patients with myopic CNV have demonstrated substantial visual acuity gains and quality of life increases compared with photodynamic therapy. These enhanced outcomes provide updated evidence-based clinical management guidelines of myopic CNV, and increase the need for a generally accepted definition for myopic CNV. This review critically summarises the latest myopic CNV literature in the context of clinical experience and recommends a myopic CNV treatment algorithm.

SUBMITTER: Wong TY

PROVIDER: S-EPMC4345796 | biostudies-other | 2015 Mar

REPOSITORIES: biostudies-other

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Myopic choroidal neovascularisation: current concepts and update on clinical management.

Wong Tien Y TY Ohno-Matsui Kyoko K Leveziel Nicolas N Holz Frank G FG Lai Timothy Y TY Yu Hyeong Gon HG Lanzetta Paolo P Chen Youxin Y Tufail Adnan A

The British journal of ophthalmology 20140701 3

Choroidal neovascularisation (CNV) is a common vision-threatening complication of myopia and pathological myopia. Despite significant advances in understanding the epidemiology, pathogenesis and natural history of myopic CNV, there is no standard definition of myopic CNV and its relationship to axial length and other myopic degenerative changes. Several treatments are available to ophthalmologists, but with the advent of new therapies there is a need for further consensus and clinical management ...[more]

PMID: 24990871

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Project description:BACKGROUND:Myopic choroidal neovascularization (CNV) is the most common sight-threatening complication associated with high myopia. The present study evaluated the efficacy and safety of the intravitreal injection of ziv-aflibercept in patients with myopic CNV. METHODS:This prospective interventional study was conducted on 20 eyes of 20 patients with active myopic CNV. Twelve patients were 40?years or older. This study was performed in the Ophthalmology Department of Tanta University Eye Hospital, Tanta University, Egypt. Optical coherence tomography (OCT) was performed for all patients at baseline and monthly after injection during the 6-month follow up period. The main outcome measures were changes in BCVA and CMT. The exploratory outcome measures were CNV size, IOP and the number of injections needed in each age group during the study period. RESULTS:Patients with myopic CNV younger than 40?years needed fewer injections (2.00?±?0.76) than patients older than 40?years (2.50?±?1.00), with no statistical significance detected between the two groups (p-value 0.246). CNV was smaller in the younger age group (p-value 0.209), best corrected visual acuity (BCVA) improved significantly in the younger and older age groups (p-values 0.001 and 0.028, respectively), and central macular thickness (CMT) decreased significantly after 6?months, from 242.88?±?23.83??m to 191.13?±?13.83??m in the younger age group and from 251.33?±?26.60??m to 197.08?±?17.64??m in the older age group (p =?0.001). No significant correlation was found between the final BCVA and either the spherical equivalent or central macular thickness after 6?months, with p-values of 0.135 and 0.145, respectively. No significant changes in IOP were detected in either group after the intravitreal injection. CONCLUSION:Ziv-aflibercept is a highly effective and safe drug in cases of active myopic CNV; however, a larger number of patients and a longer follow-up period are needed to confirm our results. This study was retrospectively registered at clinicaltrials.gov (ID: NCT04290195) on 26-2-2020.

Dataset Information

Myopic choroidal neovascularisation: current concepts and update on clinical management.

Publications

Myopic choroidal neovascularisation: current concepts and update on clinical management.

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