title: Understanding the determinants of myopic choroidal neovascularization and response to treatment.
abstract: OBJECTIVE
  The pathophysiologic pathways that govern the development of choroidal neovascularization (CNV) are complex. Patchy atrophy and lacquer cracks are known to be major anatomic risk factors for the development of myopic CNV, but they are not alone and much remains to be understood about other factors that influence development. In addition, a greater understanding of the modifiable and nonmodifiable factors that influence outcome, resolution, and recurrence after intravitreal injection of anti-vascular endothelial growth factor (VEGF) could lead to more personalized treatment algorithms that integrate parameters other than the presence of CNV itself and could help improve clinical outcomes and reduce recurrence.
  
  
  METHODS
  We reviewed recently published data on risk factors for CNV and predictors of response to anti-VEGF treatments. In particular, data pertaining to age, sex, genetic predisposition, baseline visual acuity, axial length, staphyloma, lacquer cracks, atrophic lesions, choroidal thickness or choroidal thinning, characteristics of CNV such as duration, localization, and size of CNV, and treatment considerations such as choice of treatment, loading doses, and combination treatments were reviewed.
  
  
  RESULTS
  Our analysis showed that the body of evidence is incomplete.
  
  
  CONCLUSIONS
  Additional studies are required to identify high-risk patients and to develop personalized therapeutic approaches.
authors:  Department of ophthalmology, CHU Poitiers, Poitiers - France.
authors: Nicolas
authors: N
authors: Leveziel
authors:  New Civil Hospital, University Hospitals of Strasbourg, Strasbourg - France.| Laboratory of Bacteriology (EA-7290), Federation of Medicine Translational of Strasbourg, University of Strasbourg, Strasbourg - France.
authors: David
authors: D
authors: Gaucher
authors:  Ophtalmology Department, University Hospital of Saint Roch, University of Nice Sophia Antipolis, Nice - France.
authors: Stéphanie
authors: S
authors: Baillif
authors:  Clinic of Union, Union - France.
authors: Xavier
authors: X
authors: Benouaich
authors:  Novartis, Rueil-Malmaison - France.
authors: Claire
authors: C
authors: Chartier
authors:  Ophthalmic Imaging and Laser Center, Paris - France.
authors: Thyphaine
authors: T
authors: Grenet
authors:  Honoré Cave Clinic, Montauban - France.| Department of Ophthalmology, University Hospital of Lariboisière, Paris Hospitals, Paris - France.| University Hospital of Toulouse, Purpan, Paule de Viguier, Toulouse - France.
authors: Vincent
authors: V
authors: Gualino
authors:  Private Clinic and University Hospital of Lariboisière, Paris Hospitals, Paris - France.
authors: Valérie
authors: V
authors: Krivosic
authors:  Department of Ophtalmology, University Hospital of Bordeaux, Bordeaux - France.| Department of Ophthalmology, Pellegrin Hospital, Bordeaux - France.| University of Bordeaux, France-INSERM, ISPED, INSERM Center U897-Epidemiology Biostatistics, Bordeaux - France.
authors: Marie Noelle
authors: MN
authors: Delyfer
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D047728:Myopia, Degenerative / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A