Choroidal neovascularization in pathologic myopia: recent developments in diagnosis and treatment

Choroidal neovascularization is a common cause of vision loss in patients with pathologic myopia, often resulting in irreversible central vision loss. This is particularly important because choroidal neovascularization secondary to pathologic myopia affects many people of working age. Patients may be limited in the types of tasks they can perform effectively or may even have to give up work; thus, in addition to the emotional strain, the vision loss caused by choroidal neovascularization can have a severe impact on career expectations and financial status. This is an important issue for younger patients who may be supporting themselves and their families. In this article, the epidemiology and risk factors of pathologic myopia are reviewed, as well as the pathologic mechanisms, clinical features, and diagnostic tests for choroidal neovascularization secondary to pathologic myopia. The focus of the article is on treatment options, which until recently were limited. The evidence for the beneficial effects of laser photocoagulation, photodynamic therapy with verteporfin, surgery, and other techniques in the treatment of choroidal neovascularization secondary to pathologic myopia will be evaluated.