Characteristics of patients with a favorable natural course of myopic choroidal neovascularization

Objective: To identify the characteristics of patients with myopic choroidal neovascularization (CNV) who had a favorable visual prognosis without treatment. Methods: We reviewed the medical records of 52 consecutive patients ( 57 eyes) with myopic CNV who were followed for at least 5 years after the onset of CNV. Clinical characteristics ( patient age, CNV size and location, visual acuity at onset, chorioretinal atrophy development around CNV, and degree of myopia) were compared between patients whose visual acuity 5 years after CNV onset was better than 20/40 and those whose visual acuity was worse than 20/200. Results: Among 57 eyes, eight eyes (14.0%; 8 patients) had a final visual acuity better than 20/40. On the other hand, 37 eyes ( 64.9%; 33 patients) had a final visual acuity worse than 20/200. Statistical analysis revealed that the patients with a good prognosis final visual acuity better than 20/40) were significantly younger, had significantly smaller CNV, and significantly better initial visual acuity ( Mann - Whitney U- test, p< 0.05). Juxtafoveal CNV was more frequently observed in patients with a good prognosis than in those with a poor prognosis ( Fisher's exact probability test, p< 0.05). Only one patient (12.5%) in the good prognosis group developed a very limited area of chorioretinal atrophy around the regressed CNV, while 91.9% of the patients in the poor prognosis group developed chorioretinal atrophy. Refractive status and the axial length measurements did not differ between the two groups. Conclusions: Some young patients with myopic CNV retain favorable vision over the long term without active treatment. These information might be useful to predict the visual outcome of patients with myopic CNV.