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Hospital-Based Study of Risk Factors Associated with Development of Myopic Macular Neovascularization in Highly
Ran Du1, Shiqi Xie2, Hongshuang Lu2
1Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan, duran.tmdu@gmail.com.
Introduction:
Myopic macular neovascularization (MNV) is the most common cause of a reduction of central vision in eyes with pathologic myopia, and it can progress to macular atrophy in the long term. The aim of this study was to determine the risk factors associated with the development of MNVs.
Methods:
There were 17,198 follow-up records from 5,409 eyes of 2,784 highly myopic patients that were reviewed. The general information and ophthalmic information in the records were studied. The significance of the correlations of factors associated with the development and predicting the development of myopic MNV were determined.
Results:
Being a woman (odds ratio [OR] = 0.727, p < 0.001), having a longer axial length (OR = 0.948, p < 0.001), having a poorer baseline best-correct visual acuity (BCVA, OR = 2.098, p < 0.001), having severe myopic maculopathy (overall: p < 0.001), prior myopic MNV in the fellow eye (OR = 4.105, p < 0.001), presence of patchy atrophy (overall p < 0.001), lacquer cracks (OR = 1.718, p < 0.001), prior foveal retinal detachment (RD, OR = 3.269, p < 0.001), prior macular hole (MH, OR = 0.641, p < 0.001), prior macular retinoschisis (OR = 1.533, p < 0.001), and prior macular edema (OR = 1.508, p < 0.001) were significantly correlated with the development of myopic MNV. Eyes with MNV and patchy atrophy would require an intensive follow-up examination for myopic patients as the fellow eye would have a risk of >70% for the development of myopic MNV in 3 years and nearly 80% in 5 years.
Conclusions:
Clinicians need to pay special attention to eyes with severe grades of myopic maculopathy, prior myopic MNV in the fellow eye, presence of patchy atrophy, and prior foveal retinal detachment to determine the onset of myopic MNV.
Insights
This study identified key risk factors for myopic macular neovascularization (MNV) in highly myopic patients. Early detection and monitoring are crucial for patients with severe maculopathy or fellow eye involvement to prevent vision loss.
Area of Science:
- Ophthalmology
- Medical Research
- Retinal Diseases
Background:
- Myopic macular neovascularization (MNV) is a primary cause of vision reduction in pathologic myopia.
- MNV can lead to long-term macular atrophy, significantly impacting central vision.
Purpose of the Study:
- To identify and analyze the risk factors associated with the development of myopic MNV.
- To provide insights for early detection and management strategies.
Main Methods:
- Retrospective review of 17,198 follow-up records from 5,409 eyes of 2,784 highly myopic patients.
- Analysis of general and ophthalmic information to determine correlations with MNV development.
Main Results:
- Significant risk factors identified include female sex, longer axial length, poorer baseline visual acuity, severe myopic maculopathy, and prior conditions like fellow eye MNV, patchy atrophy, lacquer cracks, retinal detachment, retinoschisis, and macular edema.
- Eyes with MNV and patchy atrophy show a >70% risk of fellow eye MNV within 3 years and nearly 80% within 5 years.
Conclusions:
- Clinicians should prioritize monitoring eyes with severe myopic maculopathy, fellow eye MNV, patchy atrophy, and foveal retinal detachment for early MNV detection.
- Intensive follow-up is recommended for high-risk eyes to mitigate vision loss.
