Progression of myopic maculopathy after treatment

1 October 2014 | Sofia Rokerya | EYE - Vitreo-Retinal

The authors report on a retrospective study carried out to evaluate long-term progression of myopic maculopathy and functional outcome in eyes treated for myopic choroidal neovascularisation (CNV) and in eyes without CNV. Fifty-four myopic eyes of 30 patients were included in the study. Data was obtained by medical records. Eyes were assigned to four groups (PDT, IVR, PDT + IVR, dry myopic maculopathy) and evaluated for best-corrected visual acuity, colour fundus photography and spectral-domain optical coherence tomography. Chorioretinal atrophy progression was quantified manually by a certified grader in all colour fundus photographs and also in the fundus autofluorescence (FAFs) performed during the last visit, using RetmarkerAMD® software (Critical Health SA, Portugal), a semi automated system. No significant differences in morphological and functional outcomes were found, on a long-term basis for three different therapeutic modalities - PDT, IVR and PDT + IVR. The morphological changes in treated eyes are more likely to be related with the natural progression of the myopic maculopathy than with the treatment modality. In eyes treated for CNV the area of macular atrophy increased significantly until the final evaluation. This reconfirms previous reports that chorioretinal atrophy can develop long after CNV has regressed, both in treated and non-treated eyes. More studies with long-term follow-up are needed to determine the real efficacy of different treatments for myopic CNV. Less myopic eyes had a better final BCVA (r=0.437, p=0.012, and r=0.458, p=0.006 respectively). Final BCVA was also inversely correlated with total and central areas of macular atrophy, (p < 0.01). Limitations of the study include the small sample size and the lack of a control group.