Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan,
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
Ophthalmic Res. 2023;66(1):293-300. doi: 10.1159/000527183. Epub 2022 Oct 19.
Myopic macular neovascularization (MNV) is the most common cause of a reduction of central vision in eyes with pathologic myopia, and it can progress to macular atrophy in the long term. The aim of this study was to determine the risk factors associated with the development of MNVs.
There were 17,198 follow-up records from 5,409 eyes of 2,784 highly myopic patients that were reviewed. The general information and ophthalmic information in the records were studied. The significance of the correlations of factors associated with the development and predicting the development of myopic MNV were determined.
Being a woman (odds ratio [OR] = 0.727, p < 0.001), having a longer axial length (OR = 0.948, p < 0.001), having a poorer baseline best-correct visual acuity (BCVA, OR = 2.098, p < 0.001), having severe myopic maculopathy (overall: p < 0.001), prior myopic MNV in the fellow eye (OR = 4.105, p < 0.001), presence of patchy atrophy (overall p < 0.001), lacquer cracks (OR = 1.718, p < 0.001), prior foveal retinal detachment (RD, OR = 3.269, p < 0.001), prior macular hole (MH, OR = 0.641, p < 0.001), prior macular retinoschisis (OR = 1.533, p < 0.001), and prior macular edema (OR = 1.508, p < 0.001) were significantly correlated with the development of myopic MNV. Eyes with MNV and patchy atrophy would require an intensive follow-up examination for myopic patients as the fellow eye would have a risk of >70% for the development of myopic MNV in 3 years and nearly 80% in 5 years.
Clinicians need to pay special attention to eyes with severe grades of myopic maculopathy, prior myopic MNV in the fellow eye, presence of patchy atrophy, and prior foveal retinal detachment to determine the onset of myopic MNV.
近视性黄斑新生血管（MNV）是病理性近视患者中心视力下降的最常见原因，并且其可在长期发展为黄斑萎缩。本研究旨在确定与 MNV 发展相关的危险因素。
回顾性分析了 2784 例高度近视患者的 5409 只眼的 17198 份随访记录，分析了记录中的一般信息和眼科信息。确定了与近视性 MNV 发展相关的因素及其发展的预测因素的相关性。
女性（比值比[OR] = 0.727，p < 0.001）、眼轴较长（OR = 0.948，p < 0.001）、基线最佳矫正视力（BCVA）较差（OR = 2.098，p < 0.001）、严重的近视性黄斑病变（整体：p < 0.001）、对侧眼先前存在近视性 MNV（OR = 4.105，p < 0.001）、存在斑片状萎缩（整体 p < 0.001）、漆裂纹（OR = 1.718，p < 0.001）、先前发生过黄斑裂孔（OR = 0.641，p < 0.001）、先前发生过黄斑视网膜脱离（OR = 3.269，p < 0.001）、先前发生过黄斑劈裂（OR = 1.533，p < 0.001）、先前发生过黄斑水肿（OR = 1.508，p < 0.001）与近视性 MNV 的发展显著相关。患有 MNV 和斑片状萎缩的眼睛需要对近视患者进行强化随访检查，因为对侧眼在 3 年内发生近视性 MNV 的风险>70%，在 5 年内发生近视性 MNV 的风险接近 80%。
临床医生需要特别注意严重程度的近视性黄斑病变、对侧眼先前存在近视性 MNV、存在斑片状萎缩以及先前发生过黄斑视网膜脱离的眼睛，以确定近视性 MNV 的发病情况。
