Choroidal neovascularization secondary to pathological myopia

Myopic choroidal neovascularization(m CNV), one of the complications of pathological myopia, is also one of the leading causes of visual impairment worldwide. The socioeconomic impact of mC NV in Asian countries is particularly significant due to the rising incidence of pathological myopia. There have been major advances in the treatment of mC NV in the past few years. Previous treatment modalities, such as thermal laser photocoagulation and photodynamic therapy, aimed to prevent vision loss;however, newer modalities such as intravitreal anti-vascular endothelial growth factor(VEGF) agents have been shown to successfully restore vision in many patients. Challenges remain as long term safety and efficacy of anti-VEGF agents are unknown. This article aims to provide a review of the literature of the epidemiology, progression, clinical course and treatment modalities as well as areas of future developments related to myopic CNV.

Optical coherence tomography angiography in diabetic retinopathy: a review of current applications

Background:Diabetic retinopathy(DR)is a leading cause of vision loss in adults.Currently,the standard imaging technique to monitor and prognosticate DR and diabetic maculopathy is dye-based angiography.With the introduction of optical coherence tomography angiography(OCTA),it may serve as a potential rapid,non-invasive imaging modality as an adjunct.Main text:Recent studies on the role of OCTA in DR include the use of vascular parameters e.g.,vessel density,intercapillary spacing,vessel diameter index,length of vessels based on skeletonised OCTA,the total length of vessels,vascular architecture and area of the foveal avascular zone.These quantitative measures may be able to detect changes with the severity and progress of DR for clinical research.OCTA may also serve as a non-invasive imaging method to detect diabetic macula ischemia,which may help predict visual prognosis.However,there are many limitations of OCTA in DR,such as difficulty in segmentation between superficial and deep capillary plexus;and its use in diabetic macula edema where the presence of cystic spaces may affect image results.Future applications of OCTA in the anterior segment include detection of anterior segment ischemia and iris neovascularisation associated with proliferative DR and risk of neovascular glaucoma.Conclusion:OCTA may potentially serve as a useful non-invasive imaging tool in the diagnosis and monitoring of diabetic retinopathy and maculopathy in the future.Future studies may demonstrate how quantitative OCTA measures may have a role in detecting early retinal changes in patients with diabetes.