Is ellipsoid zone integrity essential for visual recovery in myopic neovascularization after anti-VEGF therapy?

Milani, Paolo; Pellegrini, Marco; Massacesi, Amedeo; Moschini, Stefania; Setaccioli, Marco; Soranna, Davide; Zambon, Antonella; Bottoni, Ferdinando; Bergamini, F.

doi:10.1007/s00417-017-3706-x

Cited by 12 publications

(6 citation statements)

References 24 publications

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“…At the last visit, eyes with a continuous ellipsoid zone in the central fovea usually had better visual outcomes. This result is compatible with the findings of previous reports [ 15 , 16 , 24 , 25 ]. For eyes with a discontinuous ellipsoid zone, the SH may be thick and reach beyond the ellipsoid zone; thus, severe damage to the retinal structure may limit visual recovery after hemorrhage absorption [ 16 ].…”

Section: Discussionsupporting

confidence: 94%

Long-Term Natural Outcomes of Simple Hemorrhage Associated with Lacquer Crack in High Myopia: A Risk Factor for Myopic CNV?

Liu

Zhang

et al. 2018

Journal of Ophthalmology

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Purpose To investigate the relationship between simple hemorrhage (SH) associated with lacquer crack (LC) and myopic choroidal neovascularization (CNV) in high myopia. Methods A cross-sectional evaluation including best-corrected visual acuity (BCVA), axial length, refractive error, color fundus photography, and spectral domain optical coherence tomography (SD-OCT) was performed in patients diagnosed with high myopia and SH. Fundus fluorescein angiography and indocyanine green angiography were performed if the eye was suspected with CNV. Results Thirty-three eyes of 27 patients with SH were enrolled in the study. None of the eyes developed CNV at final examination following the occurrence of hemorrhage. Recurrent hemorrhage was observed in 36.5% of the eyes. Compared with the initial BCVA, the final BCVA was significantly improved (P < 0.001) and correlated with the integrity of the ellipsoid zone in SD-OCT. There was no significant difference in the final BCVA between group 1 (LC crossed the central fovea) and group 2 (no LC crossed the central fovea) (P = 0.299). Conclusions SH associated with LC is not a risk factor for the development of myopic CNV in patients with high myopia. LCs have little influence on the final BCVA unless the integrity of the ellipsoid zone in the central fovea is disrupted.

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Section: Discussionsupporting

confidence: 94%

Long-Term Natural Outcomes of Simple Hemorrhage Associated with Lacquer Crack in High Myopia: A Risk Factor for Myopic CNV?

Liu

Zhang

et al. 2018

Journal of Ophthalmology

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“…This was consistent with previous studies finding a BCVA correlation in EZ structural integrity ( 18 , 20 – 23 ). However, it is not consistent with Milani's view ( 24 ). He found that even in absence of EZ at baseline and final follow-up, it was observed to be increased BCVA.…”

Section: Discussioncontrasting

confidence: 84%

Factors associated with the recurrence of choroidal neovascularization in pathologic myopia

Jing

Bo²,

Wang

2022

Front. Med.

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PurposeTo investigate the factors associated with the recurrence of pathologic myopia choroidal neovascularization (PM-CNV).MethodsForty-eight eyes of 48 patients with PM-CNV treated with conbercept at least 6 months of follow-up were included. Appearance of ellipsoid zone (EZ) and retinal pigment epithelium (RPE) observed on optical coherence tomography (OCT). Hyperreflective foci (HRF) height measured on OCT. Observation of CNV shape on OCT-angiography (OCTA). PM-CNV area measured on OCTA. To observe relationship between these factors and best corrected visual acuity (BCVA) and PM-CNV recurrence.ResultsThe 48 patients (48 eyes) with PM-CNV were divided into two groups: yielding a group of 20 eyes with type 1 and a group of 28 eyes with type 2. The BCVA of type 1 was better than type 2 before and after treatment (P < 0.005). Smaller HRF height (P < 0.001) and CNV area (P < 0.001) for type 1 than type 2. The appearance of EZ and RPE were intact (P < 0.001). Spearman correlation analysis found that final BCVA was significantly associated with baseline BCVA, HRF height, and appearance of EZ (P < 0.05). Binary logistics regression analysis revealed that PM-CNV recurrence was significantly correlated not only HRF height and CNV area, but also with appearance of EZ, and RPE (P < 0.05).ConclusionPM-CNV had a higher recurrence ratio. Baseline BCVA and clinical features play an important role for vision prognosis. Factors associated with PM-CNV recurrence include HRF height, CNV area, and changes in EZ and RPE structure.

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“…The integrity of the ellipsoid zone at baseline was also one of the factors predicting better final visual acuity after anti-vascular endothe-lial growth factor treatment in patients with myopic neovascularization. 9 These studies significantly improved our understanding of pathogenic mechanisms leading to vision loss in pathological myopia. Compared to qualitative observations, quantitative analysis would provide much more detailed information regarding small and seemingly minor changes, enabling early detection of photoreceptor degeneration.…”

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confidence: 99%

Visual Acuity in Pathological Myopia Is Correlated With the Photoreceptor Myoid and Ellipsoid Zone Thickness and Affected by Choroid Thickness

Shen

Huang

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To quantify the thickness of the outer retinal sublayers and choroid in pathological myopia and examine associations between these factors and best-corrected visual acuity (BCVA). METHODS. The cohort was composed of 21 eyes with emmetropia and 70 eyes with high myopia (49 simple high myopia; 21 pathological myopia). Optical coherence tomography images were segmented to determine macular thicknesses of the choroid and the following outer retinal sublayers: outer plexiform layer (OPL), Henle fiber layer and outer nuclear layer (HFL þ ONL), myoid and ellipsoid zone (MEZ), outer segment of photoreceptors (OS), and interdigitation zone and RPE/Bruch complex (IZ þ RPE). Correlations between BCVA and thickness of the outer retinal sublayers and choroid were determined. RESULTS. In pathological myopia, the choroid, HFL þ ONL, MEZ, and IZ þ RPE were thinner than in emmetropia and simple high myopia (P < 0.05). Simple and multiple regression models showed that MEZ thickness was correlated with BCVA (both P < 0.001). The relationship between MEZ thickness and BCVA varied with choroidal thickness (P ¼ 0.006). For a constant MEZ thickness, thinner choroids were associated with worse vision. In the final multiple regression predictive model, MEZ thickness, choroidal thickness, and interaction between MEZ and choroidal thickness (all P < 0.001) were predictors of BCVA. CONCLUSIONS. Outer retinal alterations, especially thinning of the MEZ, occurred in pathological myopia. The MEZ thickness was associated with BCVA, and this relationship was affected by choroidal thickness.

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Is ellipsoid zone integrity essential for visual recovery in myopic neovascularization after anti-VEGF therapy?

Cited by 12 publications

References 24 publications

Long-Term Natural Outcomes of Simple Hemorrhage Associated with Lacquer Crack in High Myopia: A Risk Factor for Myopic CNV?

Long-Term Natural Outcomes of Simple Hemorrhage Associated with Lacquer Crack in High Myopia: A Risk Factor for Myopic CNV?

Factors associated with the recurrence of choroidal neovascularization in pathologic myopia

Visual Acuity in Pathological Myopia Is Correlated With the Photoreceptor Myoid and Ellipsoid Zone Thickness and Affected by Choroid Thickness

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