Characteristics of choroidal neovascularization in elderly eyes with high myopia not meeting the pathologic myopia definition

Abstract

The META-Analysis of Pathologic Myopia Study group proposed a new classification system for myopic maculopathy (MM) with pathologic myopia (PM) defined as MM equal to/more serious than diffuse atrophy or the presence of plus lesions and myopic choroidal neovascularization (mCNV) defined as CNV in the eye with PM. However, CNV in elderly eyes with high myopia (HM) not meeting the PM definition (high-myopia CNV) are not classified as age-related macular degeneration (nAMD) or mCNV. This retrospective study included 39 eyes with high-myopia CNV, 20 eyes with mCNV, and 20 eyes with AMD. All patients were at least 40 years old. We compared the clinical characteristics and treatment outcomes among three groups. The high-myopia CNV group had significantly more CNV types, shorter axial length and fewer lacquer cracks (P < 0.0001, respectively); larger baseline greatest linear dimension (P = 0.0002), more fellow-eye drusen (P = 0.0106), more men (P = 0.0029), and more treatments (24 months, P = 0.0098) compared to the mCNV group. Compared with the nAMD group, the high-myopia CNV group was significantly younger (P = 0.0041), and had fewer CNV types (P = 0.0316), more lacquer cracks (P = 0.0079) and fewer drusen (affected-eye, P = 0.0006 and fellow-eye, P = 0.0222), and fewer treatments (24 months, P = 0.0030). Because the CNV in elderly eyes with HM not meeting the PM definition is classified as combined mCNV and nAMD, the clinical and angiographic findings are critical to determine the treatment strategy.

IMI 2023 Digest

“…Choroidal neovascularization in eyes with high myopia that do not meet the pathologic myopia definition of the META-Analysis of Pathologic Myopia Study group ended up not being classified as either age-related macular degeneration or myopic choroidal neovascularization. 17 …”

Efficacy of Brolucizumab in Polyp Regression of Treatment-Naive Polypoidal Choroidal Vasculopathy and Its Effect on 1-Year Treatment Outcome

“…By far, only one study by Sayanagi et al reported the effect of the percentage change of polyp reduction, in cases where incomplete polyp regression was found after loading injection in treatment outcome. [15] Sayanagi et al reported that the degree of polyp reduction was associated with BCVA at 3-month but not with BCVA at 12-month, CMT at 3 and 12-month, total number of injections and dry macula status at 3 and 12-month. In our study, polyp reduction rate was associated with CMT change from baseline at 3-month but not with BCVA change at 3 and 12-month, dry macula status at 3 and 12-month and total number of injections.…”

“…Among them are factors such as size and number of polyps, size of vascular lesion including BNN and complete polyp regression rate after loading injection of anti-VEGF. [14,15] As far as we know, only one study analyzed the effect of polyp size reduction on treatment outcome in cases where there was incomplete regression of polyp after loading injections. [15] Also, most of the previous studies mainly focused on the efficacy of ranibizumab, aflibercept and PDT combined with anti-VEGF in polyp regression and its effect on treatment outcome, but not brolucizumab.…”

“…[14,15] As far as we know, only one study analyzed the effect of polyp size reduction on treatment outcome in cases where there was incomplete regression of polyp after loading injections. [15] Also, most of the previous studies mainly focused on the efficacy of ranibizumab, aflibercept and PDT combined with anti-VEGF in polyp regression and its effect on treatment outcome, but not brolucizumab. [15][16][17] In the present study, we aimed to evaluate one-year treatment outcome of brolucizumab in Korean treatmentnaïve PCV patients and analyze complete polyp regression rate after loading phase.…”

“…[15] Also, most of the previous studies mainly focused on the efficacy of ranibizumab, aflibercept and PDT combined with anti-VEGF in polyp regression and its effect on treatment outcome, but not brolucizumab. [15][16][17] In the present study, we aimed to evaluate one-year treatment outcome of brolucizumab in Korean treatmentnaïve PCV patients and analyze complete polyp regression rate after loading phase. Also, we aimed to analyze the effect of complete polyp regression and the impact of vascular lesion size and polyp area reduction in one-year treatment outcome.…”