The pathophysiologic pathways that govern the development of choroidal neovascularization (CNV) are complex. Patchy atrophy and lacquer cracks are known to be major anatomic risk factors for the development of myopic CNV, but they are not alone and much remains to be understood about other factors that influence development. In addition, a greater understanding of the modifiable and nonmodifiable factors that influence outcome, resolution, and recurrence after intravitreal injection of anti-vascular endothelial growth factor (VEGF) could lead to more personalized treatment algorithms that integrate parameters other than the presence of CNV itself and could help improve clinical outcomes and reduce recurrence.
We reviewed recently published data on risk factors for CNV and predictors of response to anti-VEGF treatments. In particular, data pertaining to age, sex, genetic predisposition, baseline visual acuity, axial length, staphyloma, lacquer cracks, atrophic lesions, choroidal thickness or choroidal thinning, characteristics of CNV such as duration, localization, and size of CNV, and treatment considerations such as choice of treatment, loading doses, and combination treatments were reviewed.
Our analysis showed that the body of evidence is incomplete.
Additional studies are required to identify high-risk patients and to develop personalized therapeutic approaches.
Eur J Ophthalmol 2016; 26(6): 511 - 516
Article Type: REVIEW
AuthorsNicolas Leveziel, David Gaucher, Stéphanie Baillif, Xavier Benouaich, Claire Chartier, Thyphaine Grenet, Vincent Gualino, Valérie Krivosic, Marie Noelle Delyfer
- • Accepted on 29/06/2016
- • Available online on 01/08/2016
- • Published in print on 04/11/2016
This article is available as full text PDF.
- Leveziel, Nicolas [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Gaucher, David [PubMed] [Google Scholar] 2, 3
- Baillif, Stéphanie [PubMed] [Google Scholar] 4
- Benouaich, Xavier [PubMed] [Google Scholar] 5
- Chartier, Claire [PubMed] [Google Scholar] 6
- Grenet, Thyphaine [PubMed] [Google Scholar] 7
- Gualino, Vincent [PubMed] [Google Scholar] 8, 9, 10
- Krivosic, Valérie [PubMed] [Google Scholar] 11
- Delyfer, Marie Noelle [PubMed] [Google Scholar] 12, 13, 14
Department of ophthalmology, CHU Poitiers, Poitiers - France
New Civil Hospital, University Hospitals of Strasbourg, Strasbourg - France
Laboratory of Bacteriology (EA-7290), Federation of Medicine Translational of Strasbourg, University of Strasbourg, Strasbourg - France
Ophtalmology Department, University Hospital of Saint Roch, University of Nice Sophia Antipolis, Nice - France
Clinic of Union, Union - France
Novartis, Rueil-Malmaison - France
Ophthalmic Imaging and Laser Center, Paris - France
Honoré Cave Clinic, Montauban - France
Department of Ophthalmology, University Hospital of Lariboisière, Paris Hospitals, Paris - France
University Hospital of Toulouse, Purpan, Paule de Viguier, Toulouse - France
Private Clinic and University Hospital of Lariboisière, Paris Hospitals, Paris - France
Department of Ophtalmology, University Hospital of Bordeaux, Bordeaux - France
Department of Ophthalmology, Pellegrin Hospital, Bordeaux - France
University of Bordeaux, France-INSERM, ISPED, INSERM Center U897-Epidemiology Biostatistics, Bordeaux - France