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. 2024 Jul;262(7):2005-2026.
doi: 10.1007/s00417-023-06320-w. Epub 2023 Dec 7.

Differential diagnosis of myopic choroidal neovascularization (mCNV): insights from multimodal imaging and treatment implications

Alessandro Feo  1 , Luca De Simone  2 , Luca Cimino  2 , Martina Angi  3 , Mario R Romano  4   5
Affiliations

Differential diagnosis of myopic choroidal neovascularization (mCNV): insights from multimodal imaging and treatment implications

Alessandro Feo et al. Graefes Arch Clin Exp Ophthalmol. 2024 Jul.

Abstract

Purpose: The aim of this article is to conduct a comprehensive systematic review about the current understandings and differential diagnosis of myopic choroidal neovascularization (mCNV) and other several similar diseases, describing their multimodal imaging analysis, prognostic implications, and current types of management.

Methods: This systematic review was performed based on a search on the PubMed database of relevant papers regarding mCNV and other entities discussed in the paper, according to our current knowledge.

Results: Through the integration of a multimodal imaging approach, especially optical coherence tomography (OCT), along with accurate demographic and clinical assessment, it becomes possible to effectively differentiate mCNV from similar yet heterogeneous entities. These conditions include macular hemorrhage due to new lacquer crack (LC) formation, inflammatory diseases such as punctate inner choroidopathy (PIC)/multifocal choroidits (MFC) and epiphenomenon multiple evanescent white dot syndrome (Epi-MEWDS), neovascular age-related macular degeneration (nAMD), idiopathic CNV (ICNV), dome-shaped macula (DSM) with subretinal fluid, retinal pigment epithelium (RPE) humps, angioid streaks (AS), choroidal rupture (CR), and choroidal osteoma (CO). Each one of these entities will be described and discussed in this article.

Conclusion: Myopic choroidal neovascularization is a common retinal condition, especially among young individuals. Accurate diagnosis and differentiation from similar conditions are crucial for effective treatment. Multimodal imaging, particularly OCT, plays a crucial role in precise assessment. Future research should focus on defining biomarkers and distinguishing features to facilitate prompt treatment.

Keywords: Anti-VEGF therapy; Differential diagnosis; Inflammatory choroidal neovascularization; Multimodal imaging; Myopic choroidal neovascularization; Pathologic myopia.

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