Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review

Purpose: To summarize the epidemiology of pathologic myopia and myopic choroidal neovascularization (CNV) and their impact on vision.

Design: Systematic literature review of all English-language studies evaluating the epidemiology and visual burden of pathologic myopia or myopic CNV.

Methods: PubMed and EMBASE were searched with no time limits using predefined search strings for English-language studies evaluating the epidemiology and visual burden of pathologic myopia and myopic CNV.

Results: In total, 39 relevant publications were identified. Population-based studies reported pathologic myopia to be the first to third most frequent cause of blindness. The prevalence of pathologic myopia was reported to be 0.9%-3.1%, and the prevalence of visual impairment attributable to pathologic myopia ranged from 0.1%-0.5% (European studies) and from 0.2%-1.4% (Asian studies). The prevalence of CNV in individuals with pathologic myopia was reported to be 5.2%-11.3%, and was bilateral in approximately 15% of patients. All studies of visual outcome in patients with myopic CNV (duration ranging from less than 3 months to 21.5 years) reported deterioration in best-corrected visual acuity over time. Older age, subfoveal CNV location, and larger baseline lesion size were predictors of worse visual outcomes.

Conclusions: Pathologic myopia is an important cause of vision loss worldwide, affecting up to 3% of the population. Of these, a substantial proportion of patients develop myopic CNV, which mostly causes a significant progressive decrease in visual acuity. This condition should therefore be a target for new treatment strategies.