Myopic Choroidal Neovascularization: Review, Guidance, and Consensus Statement on Management

Area of Science:

• Ophthalmology
• Retinal Diseases
• Vascular Biology

Background:

• Myopic choroidal neovascularization (CNV) is a severe complication of pathologic myopia, affecting millions globally.
• It causes sudden, progressive central vision loss and carries a poor prognosis without treatment.
• Bilateral involvement occurs in 35% of patients within 8 years, highlighting the need for effective management.

Purpose of the Study:

• To review and compile information on myopic CNV classification, pathophysiology, and clinical features.
• To describe the latest management data and provide clinical guidance for myopic CNV.
• To address gaps in understanding and optimal treatment administration for myopic CNV.

Main Methods:

• A comprehensive literature review was conducted in September 2015.
• Searches included English-language articles in PubMed using terms related to choroidal neovascularization and myopia.
• 223 relevant articles were identified and used for the review.

Main Results:

• The review synthesized data on the classification, pathophysiology, and clinical presentation of myopic CNV.
• Current management strategies, including anti-vascular endothelial growth factor (VEGF) therapies, were evaluated.
• Significant knowledge gaps regarding long-term safety and efficacy of treatments were identified.

Conclusions:

• Patients with high myopia experiencing sudden central vision loss require prompt referral and examination.
• Early diagnosis via fluorescein angiography and immediate initiation of anti-VEGF therapy are crucial.
• Continuous patient monitoring is essential to detect disease progression or recurrence.