Surgical removal of subfoveal choroidal neovascularization in pathologic myopia: a 12-year follow-up study

Abstract

The purpose of this study was to review the 12-year visual outcomes of patients who underwent surgical removal for subfoveal choroidal neovascularization (CNV) attributable to pathologic myopia. This retrospective study included 14 patients, with a mean age of 45.8years, high myopia (>6D) and classic subfoveal CNV. They were treated with pars plana vitrectomy and surgical removal of CNV. All patients were followed up every 3months for 2years, with visual acuity (VA), fundus examination, and fluorescein angiography and then every year for 5years. Ten patients underwent a final visit with VA and fundus examination after a minimum 12-year follow-up. The main outcome measurement was VA and the secondary outcome measurement was the lesion size. After 12years of follow-up, the mean VA did not significantly change over time, with a mean gain of 0.22 logMAR at 1year, and 0.18, 0.12 and 0.05 at 2, 5 and 12years, respectively. The anatomical evolution was characterized by a significant enlargement of the lesion size at 5years. This study showed that final VA after surgical treatment with 12years of follow-up was poor, due to the significant CNV scar enlargement over time. These results should prompt a prospective randomized study of other medical treatments, particularly anti-vascular endothelial growth factor therapy.