Myopic choroidal neovascularization: management issues remain

In the modern world, myopia continues to be one of the most common refractive errors and is considered a socially signifi cant problem, since it is a common cause of decreased vision. In connection with the growth of myopia, the risk of developing complications in the fundus increases, leading to the development of degenerative changes in the retina and an irreversible decrease in visual functions in young and middle-aged people. One of these complications is myopic choroidal neovascularization, which leads to a progressive, irreversible decrease in visual acuity and poor prognosis, and the process is often bilateral in nature. The tactics of managing patients with such complications has been determined: antiangiogenic therapy is used – intravitreal therapy with anti-VEGF drugs, which is currently the fi rst choice therapy for this pathology. But in some cases, antiangiogenic therapy is contraindicated, and the question arises about the tactics of managing such patients. The aim: to study treatment options for myopic choroidal neovascularization in patients with myopia in different situations.Material and methods. The paper presents two clinical observations of patients with mChNV, considers the tactics of their management. The patients underwent standard ophthalmological examination, optical coherence tomography (OCT) and OCT-Angio (OPTOPOL Technology, Poland).Conclusions. Women with myopia planning pregnancy need a thorough examination not only by a clinician, but also by an ophthalmologist, since it is necessary to take into account not only the degree of myopia and choose the optimal delivery method, but also to study the state of the retina for the timely diagnosis of degenerative changes in the fundus.

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Current and emerging treatment options for myopic choroidal neovascularization

Clinical Ophthalmology ◽

10.2147/opth.s49437 ◽

2015 ◽

pp. 733 ◽

Cited By ~ 14

Author(s):

Leila El Matri ◽

Ahmed Chebil ◽

Fedra Kort

Keyword(s):

Choroidal Neovascularization ◽

Treatment Options ◽

Myopic Choroidal Neovascularization

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Structural and optical coherence tomography angiography in myopic choroidal neovascularization: Agreement with conventional fluorescein angiography

European Journal of Ophthalmology ◽

10.1177/1120672119882333 ◽

2019 ◽

pp. 112067211988233 ◽

Cited By ~ 1

Author(s):

Pierluigi Iacono ◽

Paola Giorno ◽

Monica Varano ◽

Mariacristina Parravano

Keyword(s):

Optical Coherence Tomography ◽

Fluorescein Angiography ◽

Choroidal Neovascularization ◽

Optical Coherence Tomography Angiography ◽

Subretinal Fluid ◽

Final Visit ◽

Ophthalmological Examination ◽

Optical Coherence ◽

External Limiting Membrane ◽

Myopic Choroidal Neovascularization

Purpose: To evaluate the agreement between fluorescein angiography and structural optical coherence tomography in diagnosing and monitoring the activity of myopic choroidal neovascularization and to provide a comparative analysis with optical coherence tomography angiography. Methods: Thirteen patients with active myopic choroidal neovascularization were prospectively enrolled. At the baseline, 2-month, and 6-month visits, each patient underwent a complete ophthalmological examination, including best-corrected visual acuity assessment, fundus examination, fluorescein angiography, and optical coherence tomography with structural and angiographic assessment. Sensitivity and specificity for all optical coherence tomography parameters were evaluated taking fluorescein angiography as the reference examination. Results: At the baseline, fluorescein angiography confirmed myopic choroidal neovascularization leakage in all patients. Structural optical coherence tomography demonstrated intraretinal or subretinal fluid in 61% of cases, fuzzy borders and absence of external limiting membrane visibility in 84% of cases, and subretinal hyperreflective exudation in 53% of cases. Sensitivity to the presence of retinal fluid and subretinal hyperreflective exudation was lower than sensitivity to fuzzy borders and external limiting membrane visibility, which reached 84%. During ranibizumab therapy, external limiting membrane visibility showed a higher sensitivity (100%) compared with fuzzy borders and subretinal hyperreflective exudation (66.6%) while displaying an equal specificity of 100%. At baseline and final visit, sensitivity increased to 100% when all structural optical coherence tomography parameters were pooled. Optical coherence tomography angiography detected myopic choroidal neovascularization at baseline, 2-month, and 6-month visits in 92%, 76%, and 76% of cases, respectively. Conclusion: The study confirms that the new indicators of myopic choroidal neovascularization activity are more reliable than the presence or absence of retinal fluid. Optical coherence tomography angiography identified myopic choroidal neovascularization in most patients in the diagnostic phase and during treatment monitoring and could be considered as an alternative to fluorescein angiography in selected patients.

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Pharmacotherapy of Myopic Choroidal Neovascularization

Current Pharmaceutical Design ◽

10.2174/1381612825666190124102641 ◽

2019 ◽

Vol 24 (41) ◽

pp. 4853-4859 ◽

Cited By ~ 2

Author(s):

Hacer Isildak ◽

Stephen G. Schwartz ◽

Harry W. Flynn

Keyword(s):

Choroidal Neovascularization ◽

Treatment Options ◽

Lesion Size ◽

Pharmacologic Therapy ◽

Myopic Choroidal Neovascularization ◽

First Line Therapy ◽

Anti Vegf ◽

The Us ◽

Endothelial Growth Factor ◽

Myopic Cnv

Background: Myopic choroidal neovascularization (CNV) is a common cause of central visual loss in patients with high myopia, and the most common form of CNV in younger individuals. Pharmacologic therapy is the current mainstay of treatment of these patients. Methods: Review of pharmacological treatment options for myopic CNV, which primarily involves intravitreal administration of anti-vascular endothelial growth factor (anti-VEGF) agents. Results: At this time, anti-VEGF therapy agents are the first-line therapy in these patients. Comparative trials have not identified any major differences in treatment outcomes between aflibercept, bevacizumab, and ranibizumab. Only ranibizumab is approved for this indication in the US. Best visual outcomes are associated with younger age, smaller lesion size, and absence of chorioretinal atrophy. Conclusion: Anti-VEGF therapy is generally very effective in the treatment of myopic CNV.

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