Colin Tan, Alex Tham, Tiakumzuk Sangtam, Kah-Guan Au Eong

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MYOPIC CHOROIDAL NEOVASCULARISATION
A review of the natural history and prognostic
factors

• Colin Tan, Alex Tham, Tiakumzuk Sangtam, Kah-Guan
  Au Eong

National Healthcare Group Eye Institute,
Singapore
The authors have no financial or proprietary
interest in the subject of this topic
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OBJECTIVE METHODS

• Objective
• To review the
• Epidemiology
• Natural history
• Prognostic factors
• of myopic choroidal neovascularisation (CNV),
  a potentially blinding condition.
• Methods
• Systematic PubMed search was performed to review
  English-language publications on myopic CNV

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RESULTS

• High myopia was the aetiological factor in 62 of
  cases
• One study of 354 eyes with myopic CNV
  demonstrated that 96 of choroidal neovascular
  membranes remained stable or regressed with
  scarring.
• However, the visual prognosis of untreated myopic
  CNV is poor, with final visual acuities (VA) of
  20/100 or less in several studies.

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RESULTS

• Review of 100 untreated eyes
• After 5 years
• 100 of lesions involved the foveal center
• Mean visual acuity of 20/160.
• Visual acuity significantly lower than similar
  group treated with laser photocoagulation
• 10-year follow-up of 27 Asian eyes
• VA dropped to 20/200 or worse
• After 5 years 88.9
• After 10 years 96.3
• Prognostic factors for visual outcome of myopic
  CNV
• Age at onset of CNV
• Location and size of CNV
• Initial best-corrected visual acuity.

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RESULTS
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CONCLUSION

• Pathologic myopia is the cause of CNV in a large
  proportion of patients
• Younger than 50 years of age
• Long-term visual prognosis of untreated CNV is
  poor
• Visual acuities of 20/100 or less
• After 5 to 10 years in a large proportion of
  patients