Kerala Journal of Ophthalmology (Jan 2016)
Myopic choroidal neovascular membrane: A retrospective study
Abstract
Purpose: The purpose of the study was to analyse the fundus fluorescein angiographic (FFA) and Spectral domain Optical coherence tomographic (SD- OCT) patterns of myopic CNVM and to evaluate their response to anti-VEGF. Materials and Methods: This is a retrospective analysis of 24 treatment naïve eyes diagnosed with myopic CNVM. Eyes with age related macular degeneration, coexisting diabetes mellitus, inflammatory CNVM, idiopathic CNVM and Pseudophakia were excluded.Analysis of degree of myopia, the best corrected visual acuity (BCVA) at presentation and one year after treatment, FFA features, SD-OCT images and the response to intravitreal anti VEGF injections were carried out. Results: 24 eyes of 21patients ( 6 males, 15 females) were included in the study Mean age of the patients was 44.78 ± 17.40 years.Degree of myopia ranged from -2.5D to -22 D. Fundus fluorescein angiography showed classic CNVM in all eyes with subfoveal location in 19 eyes and juxtafoveal in 5 eyes. SD-OCT imaging showed subretinal hyperreflective material with intraretinal oedema in all eyes. Intravitreal bevacizumab (1.25mg in 0.5ml) was given in 18 eyes and ranibizumab (0.5 mg in 0.5ml) in 6 eyes. Mean number of injections taken was 1.83 (range 1 to 5). At 1 year follow up,13 eyes showed improvement in BCVA (54.16%), 6 worsened (25%), 5 remained stable (20.83%). Conclusion: Myopic CNVM responds to finite number of anti-VEGF injections anatomically and visually with no associated complications. The worsening is due to degenerative changes rather than recurrence of CNVM.
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