In the United States, myopia affects approximately 34 million people (2010), and similar figures have been reported in Europe. Pathologic myopia (PM), a possible consequence of myopia, is estimated to affect up to 3% of the global population. One of the most serious complications of PM is myopic CNV, which often leads to a sudden onset but progressive decline in central vision and is associated with a poor prognosis unless treated. Furthermore, 35% of patients with myopic CNV develop bilateral disease in the fellow eye within 8 years. Although intravitreal anti-vascular endothelial growth factor (VEGF) therapies have had a major impact on the management of patients with myopic CNV, there remain significant gaps in our understanding of this condition and how to best administer treatment. Additionally, the long-term safety and efficacy of these treatments are largely unknown.
We carried out a literature review (September 2015) of all English-language articles in PubMed resulting from searches of the following terms: \"choroidal neovascularization\" AND \"myopia\" OR \"myopic macular degeneration\" OR \"degenerative myopia\" OR \"myopic maculopathy\" OR \"myopic retinopathy\" OR \"pathological myopia\" OR \"pathologic myopia.\"
We screened a total of 566 abstracts, and 250 articles were deemed relevant for full publication review. We excluded a further 71, but an additional 44 articles were identified. This resulted in 223 articles being used to develop this review.
Highly myopic patients experiencing a sudden loss of central vision should be referred for further examination. Once a diagnosis of myopic CNV has been confirmed, after fluorescein angiography, treatment initiation should be prompt and anti-VEGF agents considered as first-line therapy, unless contraindicated. Continued monitoring of patients is required to assess any progression or recurrence of the condition.
在美国,近视影响约3400万人(2010年),欧洲也有类似的报道。病理性近视(PM),近视的可能后果,据估计,影响全球人口的3%。PM最严重的并发症之一是近视性CNV,这通常会导致中心视力突然发作,但进行性下降,除非治疗,否则预后不良。此外,35%的近视CNV患者在8年内发生双侧疾病。尽管玻璃体内抗血管内皮生长因子(VEGF)治疗对近视CNV患者的治疗产生了重大影响,在我们对这种情况的理解以及如何最好地进行治疗方面仍然存在很大的差距.此外,这些治疗的长期安全性和有效性在很大程度上是未知的.
我们对PubMed的所有英文文章进行了文献综述(2015年9月),这些文章来自以下术语的搜索:“脉络膜新生血管形成”和“近视”或“近视性黄斑变性”或“退行性近视”或“近视性黄斑病变”或“近视性视网膜病变”或“病理性近视”或“病理性近视”。
我们总共筛选了566篇摘要,250篇文章被认为与全面出版审查有关。我们排除了另外71篇文章,但确定了另外44篇文章。这导致了223篇文章被用来发展这篇综述。
高度近视患者突然失去中心视力,应转诊作进一步检查。一旦诊断为近视CNV,荧光素血管造影后,应迅速开始治疗,并将抗VEGF药物视为一线治疗,除非禁忌。需要对患者进行持续监测以评估病情的任何进展或复发。