9.2

Myopic Choroidal Neovascular Membrane

Introduction:

Choroidal neovascular membrane (CNV) can occur in the setting of pathologic myopia, typically in pre-existing areas of Bruch’s membrane weakness such as lacquer cracks and chorioretinal atrophy.

Clinical Features:

This type of CNV is usually well-circumscribed, heavily pigmented, and in a background of typical myopic changes (Fig. 9.2.1). It typically involved the fovea and is a type 2, or classic, CNV subtype. Its behavior tends to be less aggressive than CNV associated with wet age-related macular degeneration.

Figure 9.2.1 Color photograph of a myopic CNV shows a well-circumscribed, darkly pigmented submacular lesion involving the inferior fovea.

OCT Features:

Acutely, the CNV complex appears as a well-circumscribed area of mixed reflectivity in the subretinal space with overlying sub- and intraretinal fluid (Fig. 9.2.2, inset lower right). Sometimes, the presence of active CNV in high myopia can be difficult to discern, even with OCT. In this setting, activity may be recognized by subtle changes on serial exams (Figs 9.2.3 to 9.2.6

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1. Central Serous Chorioretinopathy
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4. Choroidal Melanoma

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