Object: choroidal neovascularization in pathologic myopia. Purpose: to increase the treatment efficacy in patients with choroidal neovascularization (CNV) in pathologic myopia (PM) by improving the treatment algorithm, based on studying anatomical and functional outcomes of the macula and therapeutic pathomorphosis of choroidal neovascularization depending on antiangiogenic therapy. Methods: best-corrected visual acuity assessment, refractometry, OcuScan RxP Ophthalmic Ultrasound, ophthalmoscopy, color fundus photography (Topcon Fundus Camera TRC 50–X), optical coherence tomography (Stratus 3000 OCT), fluorescein angiography (Opton fundus camera). StatSoft© Statistica® 10.0 package was used to process the data. Results. For the first time, the efficacy of intravitreal ranibizumab (IR) and aflibercept (IA) was compared simultaneously for patients with PM and CNV. Within the 12-months follow-up, both ranibizumab and aflibercept were found to improve similarly the visual acuity to 0.4 ± 0.21 and to 0.38 ± 0.16, respectively; and to decrease central retinal thickness (CRT) to 226 ± 35 µm and to 226 ± 32 µm, respectively, and CNV thickness to 177 ± 78 µm and to 187 ± 51 µm, respectively. The treatment algorithm for MP patients with CNV was improved by introducing a new treatment regimen which consists in two compulsory monthly loading doses (at baseline and in a month) of a VEGF inhibitor with subsequent treatment with a pro re nata regimen. For the first time, axial length and degree of refraction were found not to affect both CNV thickness and retinal thickness. Scientific data on morphometric features of the proliferative process in the macula in pathologic myopia in comparison with the exudative form of age-related macular degeneration (AMD) was extended. Thus, in PM patients, CNV thickness was thicker by 21% and CRT was thinner by 12% as compared with AMD patients, which can be caused by the difference in pathophysiological mechanisms and degenerative processes in the macula in the formation of CNV in these diseases. Scientific data on features of therapeutic pathomorphosis in PM-related and AMD-related CNV was updated. At 12 months, there still was a difference in CNV thickness and CRT. In PM-related CNV, CNV thickness was greater than in AMD-related CNV, 173 ± 40 µm and 108 ± 39 µm, respectively. CRT was thinner in PM-related CNV as compared with AMD-related CNV, 228 ± 35 µm and 258 ± 48 µm, respectively. Results of the present work were introduced into clinical practice in Laser Microsurgery Department of SI “The Filatov Institute of Eye Disease and Tissue Therapy of the NAMS of Ukraine”, Ophthalmology Department of Non-Profit Municipal Enterprise "City Hospital" of Rivne City Council, and Ophthalmology Department of Non-Profit Municipal Enterprise of Lviv Regional Council "Lviv Regional Clinical Hospital". Sphere of application: medicine, ophthalmology.
