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Laia Gomez, M Isabel Lopez, Jose María Ruiz-Moreno, Montserrat Roura; Risk factors, clinical characteristics and management of patients with myopic choroidal neovascularization in clinical practice: Mypathway study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2479.
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© ARVO (1962-2015); The Authors (2016-present)
To describe risk factors, clinical characteristics and general disease management of patients with myopic choroidal neovascularization (mCNV) vs. patients with high myopia (HM) without CNV.
We performed an observational, retrospective cohort (review of medical records), cross-sectional, and multicenter study. Two cohorts were designed: cohort-1 and cohort-2. Patients over 18 years, with visual impairment (BCVA ≤ 20/30) due to myopic CNV, and diagnosed between 6-36 months prior to the study inclusion were included in the cohort-I. Those patients over 18 years, diagnosed with HM (without CNV) and with medical history of HM since >36 months were included in the cohort-2. Nineteen centers throughout Spain participated in the study which consecutively recruited the first 10 patients with mCNV and 3 with HM.
A total of 185 patients were included (137 in the cohort-1 and 48 in cohort-2; 143 eyes cohort-1 and 81 eyes cohort-2). The two cohorts (cohort-1 vs. cohort-2) showed similar characteristics according to sex (female: 82.5% vs. 79.2%), age (median [SD] of 55.1 [12.8] vs. 54.8 [13.8] years) and Body Mass Index (25.8 [5.3] vs. 24.2 [2.7] kg/m2). The main risk factors for developing mCNV (cohort-1 vs. cohort-2) were: family history (48.2% vs. 37.5%, non-significant [NS]), smoking history (24.8% vs. 12.5%, NS) and overweight/obesity (29.2% vs. 10.4%, p=0.027). At diagnosis, the best corrected visual acuity (BCVA) [cohort-1 vs. cohort-2] was 54.0 (17.2) vs. 70.5 (16.4) letters, and at the study visit was 61.2 (18.2) vs. 70.7 (15.2) letters. For cohort-1, the median (Q1, Q3) BCVA change from diagnosis was +5.0 (0.0, 15.0) vs. 0 (-5.0, 5.0) letters. The mean (SD) retinal thickness (diagnosis vs. study visit) was 287.3 (95.2) µm vs. 257.5 (67.3) µm. Therapeutic management in cohort-1 was mainly by antiangiogenic drugs (79.7%; median of 1.8 [1.0] injections per patient).
The most important risk factors for mCNV were family history, followed by smoking history and overweight/obesity, being more frequent in mCNV than in HM patients without mCNV. Overweight/obesity was significantly more frequent in patients with mCNV. The therapeutic management with antiangiogenic was the most common treatment for mCNV, showing an improvement in BCVA from diagnosis vs. HM patients without mCNV.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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