title: Vascular endothelial growth factor inhibitor use and treatment approach for choroidal neovascularization secondary to pathologic myopia.
abstract: Myopic choroidal neovascularization (CNV) is the most common cause of CNV in those under 50 years of age. It is a significant cause of visual loss in those with pathologic myopia. The current standard of care involves therapy with intravitreal inhibitors of vascular endothelial growth factor (VEGF).
  
  
  
  The epidemiology of myopia, high myopia, pathologic myopia, and myopic CNV is reviewed, along with a brief discussion of historical treatments. The pharmacology of the three most commonly used anti-VEGF agents is discussed, with an emphasis on the licensed drugs, ranibizumab and aflibercept. A comprehensive clinical approach to diagnosis and treatment of myopic CNV is presented.
  
  
  
  The current standard of care for myopic CNV is intravitreal inhibition of VEGF, with ranibizumab and aflibercept licensed for intraocular use. The diagnosis, OCT features of disease activity and retreatment algorithm for myopic CNV is different from wet age-related macular degeneration. In the long-term, myopic CNV may be associated with gradual, irreversible visual loss due to progressive chorioretinal atrophy, for which there is currently no treatment.
authors.affiliation: a Department of Medical Retina, Moorfields Eye Hospital NHS Foundation Trust , London , United Kingdom.
authors.forename: Kaivon
authors.initials: K
authors.lastname: Pakzad-Vaezi
authors.affiliation: a Department of Medical Retina, Moorfields Eye Hospital NHS Foundation Trust , London , United Kingdom.
authors.forename: Hemal
authors.initials: H
authors.lastname: Mehta
authors.affiliation: b Ophthalmology and Visual Sciences , University of British Columbia , Vancouver , Canada.
authors.forename: Zaid
authors.initials: Z
authors.lastname: Mammo
authors.affiliation: a Department of Medical Retina, Moorfields Eye Hospital NHS Foundation Trust , London , United Kingdom.
authors.forename: Adnan
authors.initials: A
authors.lastname: Tufail
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D002986:Clinical Trials as Topic / Q000379:methods; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D009216:Myopia / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D000069579:Ranibizumab / Q000008:administration & dosage; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors* / Q000378:metabolism; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology; D057135:Wet Macular Degeneration / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab
keywords: Aflibercept; anti-VEGF; chorioretinal atrophy; choroidal neovascularization; myopia; pathologic myopia; ranibizumab