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Author Spotlight: Overcoming Anti-VEGF Resistance Through Advanced Vascular Morphology Assessment in Choroidal Neovascularization

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Published on: August 11, 2023

INCIDENCE AND ENLARGEMENT RATE OF MYOPIC MACULAR NEOVASCULARIZATION-RELATED ATROPHY IN HIGHLY MYOPIC EYES.

Omar Moukadem^1,2, Karolina Motloch^1,2,3, Marie Couanon^1,2

¹Université Paris Cité, Ophthalmology Department, AP-HP, Hôpital Lariboisière, Paris, France.

Retina (Philadelphia, Pa.)

|November 11, 2025

Summary

In highly myopic eyes, about one-third developed atrophy related to myopic macular neovascularization (MNV) within two years. The enlargement rate of this atrophy was 0.22 mm²/year, indicating a need for close monitoring in these patients.

Keywords:

high myopia myopic MNV myopic macular atrophy myopic macular neovascularization myopic maculopathy pathologic myopia

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Area of Science:

Ophthalmology
Retinal Diseases
Medical Imaging

Background:

High myopia (HM) is associated with pathological changes in the macula.
Myopic macular neovascularization (MNV) can lead to vision loss.
Atrophy development in HM eyes with MNV requires further investigation.

Purpose of the Study:

To determine the incidence and enlargement rate (ER) of atrophy associated with myopic macular neovascularization (MNV) in highly myopic (HM) eyes.
To identify factors associated with the development of MNV-related atrophy.

Main Methods:

Retrospective observational study of HM eyes treated for MNV with a follow-up of at least 24 months.
Atrophy defined as retinal pigment epithelium (RPE) disruption on SD-OCT, measured on en face infrared images.
Inclusion criteria: HM eyes with tessellated fundus or diffuse atrophy at baseline; exclusion: preexisting RPE atrophy.

Main Results:

Out of 473 MNV eyes, 44 (34.1%) developed MNV-related atrophy after a mean follow-up of 75.4 months.
Atrophy developed at 23.37 months post-MNV onset, with an ER of 0.22 ± 0.25 mm²/year.
Larger MNV diameter and male gender were linked to increased risk of atrophy development.

Conclusions:

Approximately one-third of HM eyes without prior RPE atrophy developed MNV-related atrophy within two years of MNV onset.
The observed atrophy enlargement rate underscores the necessity for vigilant monitoring in these patients.
Early detection and monitoring of atrophy are crucial for managing vision in HM eyes with MNV.