Pío del Río Hortega University Hospital, Ophthalmology Unit. C/ Carraca s/n, Valladolid 47012, Spain.
Curr Drug Targets. 2010 May;11(5):630-44. doi: 10.2174/138945010791011929.
High myopia affects approximately 2% of general population, and is a major cause of legal blindness in many developed countries. Choroidal neovascularization (CNV) is the most common vision-threatening complication of high myopia. Different therapeutic approaches have been attempted such as thermal laser photocoagulation, surgery and photodynamic therapy with verteporfin (PDT). The visual outcome of these therapies has been reported to be better than the natural history of the condition. However, the limited visual acuity improvement after PDT monotherapy and the appearance of subretinal fibrosis and chorioretinal atrophy prompted the association of other therapies. In the past few years a tremendous advance in the knowledge of the mechanisms underling CNV secondary to high myopia and age related macular degeneration has been achieved, leading to new therapeutic targets and novel drugs and combined therapies. These new therapeutic weapons have been designed to achieve a selective shut down of choroidal new vessels. Recent reviews have been published on the natural history and therapies for myopic CNV. Ohno-Matsui reported on the natural history of the condition as well as the outcome of laser photocoagulation, surgical extraction of CNV, foveal translocation and photodynamic therapy on myopic CNV in the short-term. Soubrane et al reviewed the new advances on surgery, laser photocoagulation and PDT, considering some of the potential effects of triamcinolone, pegaptanib and ranibizumab in CNV secondary to age related macular degeneration (AMD). Novack et al reported on the pharmacological therapy of CNV in AMD. The aim of this review is to summarize the recent advances in myopic CNV pathophysiology and the new therapeutic targets and drugs that are changing the clinical management of myopic CNV.
高度近视影响约 2%的普通人群，是许多发达国家法定失明的主要原因。脉络膜新生血管（CNV）是高度近视最常见的威胁视力的并发症。已经尝试了不同的治疗方法，如热激光光凝、手术和维替泊芬（PDT）的光动力疗法。这些治疗的视觉结果报告优于疾病的自然史。然而，PDT 单一疗法后的视力提高有限，以及出现视网膜下纤维化和脉络膜视网膜萎缩，促使联合其他疗法。在过去几年中，人们对高度近视和年龄相关性黄斑变性继发 CNV 的机制有了巨大的认识进展，导致了新的治疗靶点、新型药物和联合疗法。这些新的治疗武器旨在实现对脉络膜新生血管的选择性关闭。最近已经发表了关于近视性 CNV 的自然史和治疗的综述。Ohno-Matsui 报告了该疾病的自然史以及激光光凝、CNV 手术提取、黄斑转位和 PDT 对近视性 CNV 的短期治疗结果。Soubrane 等人综述了手术、激光光凝和 PDT 的新进展，考虑了曲安奈德、贝伐单抗和雷珠单抗在年龄相关性黄斑变性（AMD）继发 CNV 中的一些潜在作用。Novack 等人报告了 AMD 中 CNV 的药物治疗。本综述的目的是总结近视性 CNV 病理生理学的最新进展以及改变近视性 CNV 临床管理的新治疗靶点和药物。
