Recurrence risk of myopic choroidal neovascularisation: a systematic review of current study

• Published in: BMJ open ophthalmology Vol. 8; no. 1; p. e001396
• Main Authors: Victor, Andi Arus, Andayani, Gitalisa, Djatikusumo, Ari, Yudantha, Anggun Rama, Hutapea, Mario Marbungaran, Ardhia, Seruni Hanna, Suryoadji, Kemal Akbar
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.10.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Choroid; Choroidal Neovascularization - epidemiology; Cohort analysis; Humans; Myopia; Myopia, Degenerative - complications; Neovascularisation; Retrospective Studies; Risk factors; Statistical analysis; Systematic Review; Visual impairment; Neovascularisation; Choroid
• ISSN: 2397-3269; 2397-3269
• DOI: 10.1136/bmjophth-2023-001396

IntroductionThe rising prevalence of myopia is a concern in ophthalmology, with myopic choroidal neovascularisation (m-CNV) significantly affecting vision. However, long-term outcomes of m-CNV management have been unsatisfactory, leading to high recurrence rates. These studies aim to identify risk factors for m-CNV recurrence.MethodsComprehensive review followed a pre-registered plan in the International Prospective Register of Systematic Reviews (PROSPERO). The search strategy used various databases including PubMed, Cochrane Library, Embase, Scopus and ScienceDirect using the keywords ‘Myopic Choroidal Neovascularization’, ‘Recurrence’ and ‘Risk’. Eligible studies were identified and analysed based on predetermined criteria. This study was registered on PROSPERO (CRD4202343461).ResultsThe systematic review included three retrospective studies investigating risk factors associated with m-CNV recurrence. These factors are: (1) requiring three or more injections for initial disease control, (2) older age, (3) larger myopic macular neovascularisation, (4) juxtafoveal CNV, (5) larger height of hyper-reflective foci (HRF) and (6) destruction or absence of the ellipsoid zone (EZ) and retinal pigment epithelium (RPE).ConclusionRisk factors for m-CNV recurrence include a greater number of required injections, older age, large macular CNV, juxtafoveal location, increased HRF height and changes in EZ and RPE structure. Understanding these factors can inform personalised treatment approaches and improve patient outcomes by identifying individuals at higher risk of recurrence and implementing proactive measures to mitigate the impact of m-CNV recurrence and progression. Further investigation is needed to enhance our understanding of the underlying mechanisms and develop innovative therapeutic approaches for effective m-CNV management.PROSPERO registration numberCRD4202343461.