Myopic Choroidal Neovascularization

Pathologic myopia has been found to be one of the increasing leading causes of visual impairment in many countries. Myopic choroidal neovascularization (CNV) is a common vision-threatening complication of myopia and pathological myopia. Diagnosis is made based on funduscopic examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT). More recently, OCT-angiography could be considered as a potentially useful tool in detecting and characterizing CNV by its morphology and determining CNV activity in a noninvasive and rapid manner.Several treatment strategies have been evaluated for myopic CNV, including focal laser photocoagulation, verteporfin photodynamic therapy, intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection, and surgical treatment. Currently, anti-VEGF therapy has become the first-line treatment for myopic CNV, and its efficacy and safety have been demonstrated by several randomized clinical trials. Once the treatment of myopic CNV has started, it is also important to evaluate the activity of myopic CNV to determine the necessity of additional treatment to prevent further progression to the atrophic stage. Therefore, clinical combination of multimodal imaging technology is recommended to achieve the accurate diagnosis and assessment of disease activity for the long-term follow-up.