title: Myopic choroidal neovascularisation: current concepts and update on clinical management.
abstract: Choroidal neovascularisation (CNV) is a common vision-threatening complication of myopia and pathological myopia. Despite significant advances in understanding the epidemiology, pathogenesis and natural history of myopic CNV, there is no standard definition of myopic CNV and its relationship to axial length and other myopic degenerative changes. Several treatments are available to ophthalmologists, but with the advent of new therapies there is a need for further consensus and clinical management recommendations. Verteporfin photodynamic therapy has been an established treatment for subfoveal myopic CNV for many years, but this treatment does not restore visual acuity and is associated with long-term chorioretinal atrophy. More recently, clinical trials investigating the efficacy and safety of anti-vascular endothelial growth factor agents in patients with myopic CNV have demonstrated substantial visual acuity gains and quality of life increases compared with photodynamic therapy. These enhanced outcomes provide updated evidence-based clinical management guidelines of myopic CNV, and increase the need for a generally accepted definition for myopic CNV. This review critically summarises the latest myopic CNV literature in the context of clinical experience and recommends a myopic CNV treatment algorithm.
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore, Singapore.
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Ohno-Matsui
authors.affiliation: Faculté de Médecine de Poitiers, Department of Ophthalmology, Poitiers, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Leveziel
authors.affiliation: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors.forename: Frank G
authors.initials: FG
authors.lastname: Holz
authors.affiliation: Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, The Chinese University of Hong Kong, People's Republic of China.
authors.forename: Timothy Y
authors.initials: TY
authors.lastname: Lai
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyeong Gon
authors.initials: HG
authors.lastname: Yu
authors.affiliation: Department of Ophthalmology, University of Udine, Piazzale S. Maria della Misericordia, Udine, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Lanzetta
authors.affiliation: Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
authors.forename: Youxin
authors.initials: Y
authors.lastname: Chen
authors.affiliation: NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
authors.forename: Adnan
authors.initials: A
authors.lastname: Tufail
mesh_terms: D000465:Algorithms; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D003661:Decision Support Techniques; D006801:Humans; D017075:Laser Coagulation; D047728:Myopia, Degenerative / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D010778:Photochemotherapy; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A
keywords: Neovascularisation; Retina; Treatment Medical