Abstract
Purpose
To examine the influencing factors on the development of chorioretinal atrophy, which is the main cause of long-term visual decrease in myopic choroidal neovascularization (CNV), in a large series of highly myopic patients.
Methods
Sixty-five patients (81 eyes) with myopic CNV were studied retrospectively. The influence of the patient’s age, refractive error, axial length, visual acuity at onset of CNV, size of CNV, and grade of myopic retinopathy on the extent of chorioretinal atrophy more than 3 years after CNV onset was investigated by means of multiple linear regression analysis.
Results
Seventy-seven of 81 eyes (95.1%) developed chorioretinal atrophy around myopic CNV during the follow-up period. Multiple linear regression revealed that age was the most influencing factor for the development of chorioretinal atrophy in all the subjects. When we divided the subjects into two groups according to their age, however, CNV size was the only factor to influence the development of chorioretinal atrophy in the patients younger than 40 years, whereas age was still the only influencing factor in those older than 40 years.
Conclusions
The factors influencing the development of chorioretinal atrophy differ according to patient age. Local factors, such as CNV size, determine the tendency to develop chorioretinal atrophy in young patients. Systemic factors, such as patient age, play a greater part in older subjects.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL (1984) Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology 91:1573–1581
Cohen SY, Laroche A, Leguen Y, Soubrane G, Coscas GJ (1996) Etiology of choroidal neovascularization in young patients. Ophthalmology 103:1241–1244
Curtin BJ (1985) Basic science and clinical management. In: Curtin BJ (ed) The myopias. Harper & Row, Philadelphia, pp 237–245
Delori FC, Goger DG, Dorey CK (2001) Age-related accumulation and spatial distribution of lipofuscin in RPE of normal subjects. Invest Ophthalmol Vis Sci 42:1855–1866
Docchio F (1989) Ocular fluorometry: principles, fluorophores, instrumentation, and clinical applications. Lasers Surg Med 9:515–532
Ghafour IM, Allan D, Foulds WS (1983) Common causes of blindness and visual handicap in the West of Scotland. Br J Ophthalmol 67:209–213
Harman AM, Hoskins R, Beazley LD (1999) Experimental eye enlargement in mature animals changes the retinal pigment epithelium. Vis Neurosci 16:619–628
Hayasaka S, Uchida M, Setogawa T (1990) Subretinal hemorrhages with or without choroidal neovascularization in the maculas of patients with pathologic myopia. Graefes Arch Clin Exp Ophthalmol 228:277–280
Hotchkiss ML, Fine SL (1981) Pathologic myopia and choroidal neovascularization. Am J Ophthalmol 91:177–183
Kitaya N, Ishiko S, Abiko T, Mori F, Kagokawa H, Kojima M, Saito K, Yoshida A (2000) Changes in blood-retinal barrier permeability in form deprivation myopia in tree shrews. Vision Res 40:2369–2377
Montero JA, Ruiz-Moreno JM (2003) Verteporfin photodynamic therapy in highly myopic subfoveal choroidal neovascularization. Br J Ophthalmol 87:173–176
Pruett RC (1994) Pathologic myopia. In: Albert DM, Jakobiec FA (eds) Principles and practice of ophthalmology. Saunders, Philadelphia, pp 878–882
Sperduto RD, Seigel D, Roberts J, Rowland M (1983) Prevalence of myopia in the United States. Arch Ophthalmol 101:405–407
Tabandeh H, Flynn HW Jr., Scott IU, Lewis ML, Rosenfeld PJ, Rodriguesz F, Rodriguesz A, Singerman LJ, Schiffman J (1999) Visual acuity outcomes of patients 50 years of age and older with high myopia and untreated choroidal neovascularization. Ophthalmology 106:2063–2067
Tokoro T (1988) On the definition of pathologic myopia in group studies. Acta Ophthalmol 66:107–108
Tokoro T (1998) Criteria for diagnosis of pathologic myopia. In: Tokoro T (ed) Atlas of posterior fundus changes in pathologic myopia. Springer, New York Berlin Heidelberg, pp 1–2
Tokoro T (1998) Myopic choroidal neovascularization (Fuchs’ spot). In: Tokoro T (ed) Atlas of posterior fundus changes in pathologic myopia. Springer, New York Berlin Heidelberg, pp 161–201
Verteporfin in Photodynamic Therapy (VIP) Study Group (2003) Verteporfin therapy of subfoveal choroidal neovascularization in pathologic myopia: 2-year results of a randomized clinical trial. VIP report no. 3. Ophthalmology 110:667–673
Yoshida A, Ishiko S, Kojima M (1996) Inward and outward permeability of the blood-retinal barrier in experimental myopia. Graefes Arch Clin Exp Ophthalmol 234: S239–242
Yoshida T, Ohno-Matsui K, Ohtake Y, Takashima T, Futagami S, Baba T, Yasuzumi K, Tokoro T, Mochizuki M (2002) Long-term visual prognosis of choroidal neovascularization in high myopia. A comparison between age groups. Ophthalmology 109:712–719
Yoshida T, Ohno-Matsui K, Yasuzumi K (2003) Myopic choroidal neovascularization: a 10-year follow-up. Ophthalmology 110:1257–1305
Acknowledgement
Supported in part by research grant 14571659 from the Japan Society for the Promotion of Science, Tokyo, Japan.
Author information
Authors and Affiliations
Corresponding author
Additional information
Presented in part as a poster at the Association for Research in Vision and Ophthalmology meeting, Fort Lauderdale, Florida, May 2003
The authors have no financial interest in any products / drugs discussed in this article
Rights and permissions
About this article
Cite this article
Kojima, A., Ohno-Matsui, K., Teramukai, S. et al. Factors associated with the development of chorioretinal atrophy around choroidal neovascularization in pathologic myopia. Graefe's Arch Clin Exp Ophthalmol 242, 114–119 (2004). https://doi.org/10.1007/s00417-003-0803-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-003-0803-9