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Eyes at the atrophic stage of myopic CNV at risk of developing macular holes, study finds

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The chorioretinal atrophy adjacent to a choroidal neovascularization in highly myopic eyes appears to increase the risk of developing a macular hole, according to a study by researchers in Japan.

Noriaki Shimada, MD, and colleagues at Tokyo Medical and Dental University performed optical coherence tomography (OCT) on 181 eyes of 125 patients with high myopia to determine whether the chorioretinal atrophy that surrounds myopic CNV is associated with the development of either macular holes or macular retinoschisis. They published their results in the January edition of American Journal of Ophthalmology.

Of the 181 eyes, 43 eyes had a myopic CNV surrounded by chorioretinal atrophy larger than 1 disc area (group 1), 45 eyes had myopic CNV surrounded by chorioretinal atrophy smaller than 1 disc area (group 2) and 93 eyes did not have CNV (group 3), according to the study.

Investigators identified a macular hole in six eyes in group 1 and in no eyes in groups 2 and 3. "The hole always existed at the border between an old CNV and the surrounding [chorioretinal atrophy]," the authors noted.

Investigators identified macular retinoschisis in four eyes in group 1 and in eight eyes in group 3. However, the macular retinoschisis detected in group 1 appeared to be less "column-like" than in group 3. Also, "it was somewhat difficult to differentiate a retinal detachment from retinoschisis in the eyes in group 1," the authors said.

"Eyes at the atrophic stage of myopic CNV have a higher risk of developing a macular hole, and we recommend periodic OCT examinations for macular holes or macular retinoschisis, even in asymptomatic, highly myopic eyes, after the CNV has progressed to the atrophic stage," they said.