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AIM:To observe the changes of macular morphology and microcirculation in myopic maculopathy(MM), and investigate theirs correlation and effects on vision.METHODS: Case-control study. A total of 165 patients(189 eyes)with high myopia and 154 healthy volunteers(154 eyes)from October 2016 to December 2018 were selected. According to the classification of Meta-analysis for pathologic myopia(META-PM), participants were divided into M0 group(category 0, 41 eyes), M1 group(category 1, 53 eyes), M2 group(category 2 and 3, 52 eyes), and myopic choroidal neovascularization(mCNV)group(43 eyes). All participants underwent optical coherence tomography angiography(OCTA)examination. Morphological and microcirculation parameters of retina at different layers were compared between groups. Pearson correlation was used to assess the correlation between morphological and microcirculation parameters. Correlations between vision and other parameters were analyzed using multiple linear regression analysis.RESULTS:Foveal full retinal thickness(FRT)and outer retinal thickness(ORT)were all lower in M0, M1 and M2 groups than those of control group(all P<0.01). Foveal superficial capillary plexus vessel density(SVD)and deep capillary plexus vessel density(DVD)were all lower in M2 and mCNV groups than those of the control group(all P<0.01). Parafoveal FRT and ORT were all lower in M0, M1, M2 and mCNV groups than those of the control group(all P<0.01). Parafoveal inner retinal thickness(IRT), SVD and DVD were all lower in M2 and mCNV groups than those of the control group(all P<0.01). Subfoveal choroidal thickness(SFCT)and choroid capillaries vessel density(CVD)were all lower in M0, M1, M2 and mCNV groups than those of the control group(all P<0.01). Foveal vessel density of retina and choroid were positively correlated with its thickness in patients with MM without CNV(all P<0.05). Multivariate analysis showed that axial length(AL), diffuse or patchy chorioretinal atrophy were influencing foctors of best corrected visual acuity(BCVA; all P<0.01).CONCLUSION:Retinal morphological changes precede microcirculation changes in MM. Most of all, ORT changes precede IRT changes. Foveal vessel density of retina and choroid were positively correlated with its thickness. The main influencing factors of BCVA were AL and types of MM.
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We report concurrent management of rhegmatogenous retinal detachment and myopic choroidal neovascularization in the left eye of a 24-year-old female who presented with sudden dimness of vision due to retinal detachment and choroidal neovascularization. Intravitreal antivascular endothelial growth factor was injected during primary vitrectomy for retinal detachment. At final follow-up, the retina was attached with scarring of choroidal neovascularization. Ours is the first report of the use of intravitreal antivascular endothelial growth factor during vitrectomy for retinal detachment.
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AIM: To investigate the change of myopic choroidal neovascularization treated by ranibizumab and evaluate their value in monitoring the effect of anti-vascular endothelial growth factor ( VEGF) therapy. ·METHODS: The study enrolled 30 patients ( 30 eyes ) diagnosed with myopic choroidal neovascularization. All affected eyes were treated with intravitreal ranibizumab 0. 05mL ( 10mg/mL ). Best corrected visual acuity ( BCVA ) , non-contact tonometer, ophthalmoscope, fundus fluorescein angiograph ( FFA ) and OCTA were evaluated monthly until 6mo. The changes of BCVA and central macular thickness ( CMT) were compared at 1, 3 and 6mo after treatment. ·RESULTS:All patients received an average of 1. 70±0. 65 injections. BCVA was 0. 96 ± 0. 17 ( LogMAR ) before therapy, and BCVA 1, 3 and 6mo after treatment respectively improved by 0. 23 ± 0. 09, 0. 34 ± 0. 07, 0. 38 ± 0. 11. The differences were significant ( t=5. 461, 8. 191, 8. 894; P<0. 05 ). Mean CMT decreased form 281. 07 ± 13. 72μm to 261. 33 ± 13. 13μm, 243. 47 ± 16. 65μm, 234. 73 ± 17. 52μm respectively 1, 3 and 6mo after treatment, showing significant differences (t=12. 007, 13. 360, 9. 531;P<0. 05). OCTA revealed a progressively smaller vascular lesion and reduction in capillary density. · CONCLUSION: Intravitreal ranibizumab for CNV secondary to pathologic myopia is effective and safe;OCTA is a noninvasive and time-saving new technology, and it also is a promising tool for clinicians to make preliminary diagnosis and assess treatment efficacy in the follow-up visits.
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PURPOSE: Using the spectral domain optical coherence tomography (SD-OCT), we studied the difference in the choroidal morphology between the choroidal neovascularization (CNV) area and the area surrounding CNV. METHODS: This retrospective study consisted of 19 patients with myopic CNV lesion in eye; fellow eyes were used as controls. All eyes were analyzed by measuring the choroidal thickness and large choroidal vessel size using SD-OCT. Eyes with CNV were divided into groups; the neovascular lesion was defined as group 1, the surrounding area as group 2. Subfovea of the fellow eye was defined as group 3. RESULTS: The choroidal thickness was 80.00 +/- 68.31 in group 1, 63.44 +/- 67.75 in group 2 and 71.11 +/- 65.69 microm in group 3. There was a significant difference between group 1 and group 2 (p = 0.038). There were no significant differences between group 1 and 3 or between group 2 and 3 (p = 0.365, p = 0.314). The large choroidal vessel size was 57.47 +/- 39.78 in group 1, 40.45 +/- 34.69 in group 2 and 45.63 +/- 37.00 microm in group 3. There was a significant difference between group 1 and group 2 (p = 0.025). There were no significant differences between group 1 and 3 or between group 2 and 3 (p = 0.123, p = 0.325). CONCLUSIONS: Choroidal thickness and large choroidal vessel size at the center of the CNV were greater than in the area surrounding CNV. The results suggest that although the CNVs were due to a thinned choroid caused by severe choroidal ischemia, the development of CNV requires maintenance of choriocapillaris and large choroid vessels.
Subject(s)
Humans , Choroid , Choroidal Neovascularization , Ischemia , Retrospective Studies , Tomography, Optical CoherenceABSTRACT
PURPOSE: To compare the efficacy of 3 consecutive monthly intravitreal bevacizumab (IVB) injections (fixed regimen group) with a single IVB injection (PRN group) on patients with myopic choroidal neovascularization (CNV) and to determine the prognostic factors associated with IVB injection outcomes. METHODS: 23 Twenty-three eyes in 21 patients with myopic CNV (14 eyes in the fixed regimen group and 9 eyes in the PRN group) treated with IVB were studied retrospectively. Best corrected visual acuity (BCVA), central macular thickness (CMT), the size of CNV prior to the initial IVB injection, CMT at the completion of treatment, and the number of IVB injections during the study period was measured. RESULTS: IVB resulted in improved BCVA and decreased CMT in both groups, and the differences before and after IVB injections were significantly correlated. Average injection time in the fixed regimen group and PRN group was 3.4 +/- 0.9 and 1.5 +/- 0.7 respectively, and was not statistically significant (p = 0.16). Differences between the groups in BCVA (p = 0.83) and CMT (p = 0.38) were not significantly correlated. Among the variables measured prior to IVB injection that affected final BCVA was age (p = 0.01). CONCLUSIONS: In the present study, a single injection of IVB compared to 3 consecutive IVB injections in patients with myopic CNV resulted in similar outcomes. In the future, these results can be considered as a reference when designing treatments for myopic CNV patients.
Subject(s)
Humans , Antibodies, Monoclonal, Humanized , Choroidal Neovascularization , Eye , Retrospective Studies , Visual Acuity , BevacizumabABSTRACT
PURPOSE: To compare the efficacy of 3 consecutive monthly intravitreal bevacizumab (IVB) injections (fixed regimen group) with a single IVB injection (PRN group) on patients with myopic choroidal neovascularization (CNV) and to determine the prognostic factors associated with IVB injection outcomes. METHODS: 23 Twenty-three eyes in 21 patients with myopic CNV (14 eyes in the fixed regimen group and 9 eyes in the PRN group) treated with IVB were studied retrospectively. Best corrected visual acuity (BCVA), central macular thickness (CMT), the size of CNV prior to the initial IVB injection, CMT at the completion of treatment, and the number of IVB injections during the study period was measured. RESULTS: IVB resulted in improved BCVA and decreased CMT in both groups, and the differences before and after IVB injections were significantly correlated. Average injection time in the fixed regimen group and PRN group was 3.4 +/- 0.9 and 1.5 +/- 0.7 respectively, and was not statistically significant (p = 0.16). Differences between the groups in BCVA (p = 0.83) and CMT (p = 0.38) were not significantly correlated. Among the variables measured prior to IVB injection that affected final BCVA was age (p = 0.01). CONCLUSIONS: In the present study, a single injection of IVB compared to 3 consecutive IVB injections in patients with myopic CNV resulted in similar outcomes. In the future, these results can be considered as a reference when designing treatments for myopic CNV patients.