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The correlation of atrophy, traction and neovascularization in myopic choroidal neovascularization according to a novel myopic maculopathy classification system (atrophy (A), traction (T), neovascularization (N): ATN)

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Abstract

Purpose

To grade myopic choroidal neovascularization (CNV) patients according to the new myopic maculopathy classification (A: atrophy, T: traction, N: neovascularization-ATN) and analyze the correlation in between atrophy, traction and neovascularization.

Methods

Fifty-one eyes of 41 patients with the diagnosis of pathologic myopia and myopic CNV were included in this clinical practice study. Patients were graded according to the recently described ATN classification. Color fundus photographs were used to grade the atrophy and spectral domain optical coherence tomography scans were used to grade traction and neovascularization. Active myopic CNVs were treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections. Chi-square test was used to test the categorical variants and univariate logistic regression analysis was used to predict the independent risk factors of myopic CNV scar formation.

Results

Active myopic CNV was observed most frequently in the group with patchy chorioretinal atrophy. Grade of the atrophy and female gender were significantly associated with myopic CNV scar in the univariate logistic regression tests. Multivariate logistic regression showed that atrophy grading is the independent predictor of myopic CNV scar.

Conclusion

ATN classification is a practical and comprehensive system to grade myopic CNV. Atrophy is an independent predictor for myopic CNV scar and patchy chorioretinal atrophy requires a more careful examination and close follow-up for the risk of CNV development.

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Availability of data and materials

Raw data will be presented upon request.

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Acknowledgements

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No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Baskent University Istanbul Hospital, Kısıklı Caddesi Oymacı Sokak No: 7, 34662, Üsküdar Istanbul, Turkey

    Rengin Aslıhan Kurt

  2. Department of Ophthalmology, Faculty of Medicine, Baskent University, Ankara, Turkey

    Almila Sarıgül Sezenöz, Imren Akkoyun & Gürsel Yılmaz

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  1. Rengin Aslıhan Kurt
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  2. Almila Sarıgül Sezenöz
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  3. Imren Akkoyun
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  4. Gürsel Yılmaz
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Contributions

All authors contributed to the study conception, design, material preparation, data collection and analysis. The first draft of the manuscript was written by Rengin Aslıhan Kurt and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Rengin Aslıhan Kurt.

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Subjects have given their written informed consent and the study protocol was approved by the ethics committee of Başkent University.

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Kurt, R.A., Sarıgül Sezenöz, A., Akkoyun, I. et al. The correlation of atrophy, traction and neovascularization in myopic choroidal neovascularization according to a novel myopic maculopathy classification system (atrophy (A), traction (T), neovascularization (N): ATN). Int Ophthalmol 42, 2925–2932 (2022). https://doi.org/10.1007/s10792-022-02423-1

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