Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
Surv Ophthalmol. 2023 Nov-Dec;68(6):1011-1026. doi: 10.1016/j.survophthal.2023.07.006. Epub 2023 Jul 28.
Myopic choroidal neovascularization (CNV) is a vision-threatening complication of high myopia. Here, we systematically review cohort, case-control, and cross-sectional studies in PubMed, Embase, and Web of Science, and summarize the associated factors of myopic CNV using meta-analysis where applicable. Among 1,333 records assessed, 50 were found eligible, all having a low-to-moderate risk of bias. Highly myopic eyes with CNV had a higher risk of lacquer cracks (odds ratio = 2.88) and patchy chorioretinal atrophy (odds ratio = 3.43) than those without. The mean posterior staphyloma height (µm) was greater in myopic CNV eyes than in highly myopic eyes without CNV (mean difference = 82.03). The thinning of choroidal thickness (µm) between myopic eyes with and without CNV differed significantly (mean difference = -47.76). The level of vascular endothelial growth factor (pg/ml) in the aqueous humor of myopic CNV eyes was significantly higher than in highly myopic eyes without CNV (mean difference = 24.98), the same as interleukin-8 (IL-8) (pg/ml, mean difference = 7.73). Single-nucleotide polymorphisms in the vascular endothelial growth factor, complement factor I, and collagen type VIII alpha 1 genes were associated with myopic CNV. We found that myopic CNV eyes have a higher ratio of lacquer cracks and patchy chorioretinal atrophy, thinner choroid, greater posterior staphyloma height, and a higher level of vascular endothelial growth factor and IL-8 in aqueous. Structural predisposing lesions, hemodynamic, genetic, and systemic factors are also associated with myopic CNV.
近视性脉络膜新生血管（CNV）是高度近视的一种致盲性并发症。在这里，我们系统地综述了在 PubMed、Embase 和 Web of Science 中收录的队列研究、病例对照研究和横断面研究，并应用荟萃分析总结了近视性 CNV 的相关因素。在评估的 1333 条记录中，有 50 条符合条件，且均具有低到中度的偏倚风险。与无 CNV 的高度近视眼相比，有 CNV 的高度近视眼发生漆裂（优势比=2.88）和斑片状脉络膜视网膜萎缩（优势比=3.43）的风险更高。近视性 CNV 眼的后巩膜葡萄肿高度（µm）大于无 CNV 的高度近视眼（平均差异=82.03）。有 CNV 的近视眼和无 CNV 的近视眼之间脉络膜厚度（µm）的变薄程度差异显著（平均差异=-47.76）。近视性 CNV 眼房水中血管内皮生长因子（pg/ml）的水平明显高于无 CNV 的高度近视眼（平均差异=24.98），与白细胞介素-8（IL-8）（pg/ml，平均差异=7.73）相同。血管内皮生长因子、补体因子 I 和 VIII 型胶原α 1 基因的单核苷酸多态性与近视性 CNV 相关。我们发现，近视性 CNV 眼的漆裂和斑片状脉络膜视网膜萎缩比例更高，脉络膜更薄，后巩膜葡萄肿高度更大，房水中血管内皮生长因子和 IL-8 水平更高。结构易损病变、血液动力学、遗传和全身因素也与近视性 CNV 相关。
