Wong Tien Y, Ohno-Matsui Kyoko, Leveziel Nicolas, Holz Frank G, Lai Timothy Y, Yu Hyeong Gon, Lanzetta Paolo, Chen Youxin, Tufail Adnan
Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore, Singapore.
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
Br J Ophthalmol. 2015 Mar;99(3):289-96. doi: 10.1136/bjophthalmol-2014-305131. Epub 2014 Jul 1.
Choroidal neovascularisation (CNV) is a common vision-threatening complication of myopia and pathological myopia. Despite significant advances in understanding the epidemiology, pathogenesis and natural history of myopic CNV, there is no standard definition of myopic CNV and its relationship to axial length and other myopic degenerative changes. Several treatments are available to ophthalmologists, but with the advent of new therapies there is a need for further consensus and clinical management recommendations. Verteporfin photodynamic therapy has been an established treatment for subfoveal myopic CNV for many years, but this treatment does not restore visual acuity and is associated with long-term chorioretinal atrophy. More recently, clinical trials investigating the efficacy and safety of anti-vascular endothelial growth factor agents in patients with myopic CNV have demonstrated substantial visual acuity gains and quality of life increases compared with photodynamic therapy. These enhanced outcomes provide updated evidence-based clinical management guidelines of myopic CNV, and increase the need for a generally accepted definition for myopic CNV. This review critically summarises the latest myopic CNV literature in the context of clinical experience and recommends a myopic CNV treatment algorithm.
脉络膜新生血管形成（CNV）是近视和病理性近视常见的威胁视力的并发症。尽管在了解近视性CNV的流行病学、发病机制和自然史方面取得了重大进展，但对于近视性CNV尚无标准定义，也不清楚其与眼轴长度及其他近视性退行性改变的关系。眼科医生有多种治疗方法可供选择，但随着新疗法的出现，需要进一步达成共识并提出临床管理建议。维替泊芬光动力疗法多年来一直是治疗黄斑中心凹下近视性CNV的既定疗法，但这种治疗方法无法恢复视力，且会导致长期脉络膜视网膜萎缩。最近，针对抗血管内皮生长因子药物治疗近视性CNV患者的疗效和安全性的临床试验表明，与光动力疗法相比，患者的视力有显著提高，生活质量也有所改善。这些更好的结果为近视性CNV提供了最新的循证临床管理指南，并增加了对近视性CNV普遍接受定义的需求。本综述结合临床经验对最新的近视性CNV文献进行了批判性总结，并推荐了一种近视性CNV治疗方案。
