BackgroundThis study aimed to summarize the features of perforating scleral vessels (PSVs) in patients with myopic choroidal neovascularization (CNV) (mCNV) using optical coherence tomography angiography (OCTA) and to identify the associations with the response after intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy.MethodsA consecutive series of naïve patients who had mCNV and received intravitreal anti-VEGF therapy with a follow-up duration of 12 months or more were enrolled. The prevalence, location, and branches of PSVs were analyzed. Projection-resolved OCTA (PR-OCTA) was used to analyze the neovascular signals between CNV and PSVs. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured. The proportion of CMT change relative to baseline was used to assess therapeutic response.ResultsA total of 44 eyes from 42 patients with mCNV were enrolled. PSVs were identified in 41 out of 44 eyes. Branches were identified in the PSVs of 24 eyes (57.14%), and 20 eyes did not have PSV branches (47.62%). In eight eyes (18.18%), PSVs were adjacent to mCNV, and in 36 eyes (81.82%), PSVs were not adjacent to mCNV. After anti-VEGF therapy for mCNV, BCVA increased (F = 6.119, p < 0.001) and CMT decreased (F = 7.664, p < 0.001). In the eyes where PSVs were adjacent to mCNV, BCVA improvements (F = 7.649, p = 0.009) were poor, and changes in CMT were small.ConclusionThe eyes with PSVs adjacent to mCNV showed poor therapeutic responses after intravitreal anti-VEGF therapy.

Objectives: To analyzed the recurrence of myopic choroidal neovascularization (mCNV) based on the neovascular signal from perforating scleral vessel (PSV) by optical coherence tomography angiography (OCTA) after anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods:A consecutive series of naïve patients with mCNV accepted anti-VEGF therapy with a minimum 12-month follow-up period. The location of PSV with CNV were classified into PSV adjacent to CNV or not by B scan and the flow signal of CNV was classified into the neovascular signal of CNV from PSV or not by OCTA. The recurrence of mCNV in various PSV with CNV types were compared. K-M survival and Cox proportional hazard model analysis were used to identify risk factors associated with recurrence of mCNV. Results: PSVs were found in 59 of 63 eyes (93.7%) with mCNV in the macular region. The eyes with presence of neovascular signal of CNV from PSV were detected 25 eyes (39.7%). The overall mCNV recurrence rate was 46.0% (29/63) during the follow-up period. According to K-M analysis, the presence of neovascularization with mCNV from PSV predicted a higher recurrence of 60% and a shorter recurrent duration (χ2 =4.486, P=0.034). The Cox proportional hazard model demonstrated that the presence of neovascularization with mCNV from PSV was an independent risk factor for recurrence (HR: 2.19, 95%Cl 1.04-4.62). Conclusions:PSV was mainly detected with mCNV. When the neovascularization of the mCNV comes from PSV, it has a greater recurrence rate with a shorter recurrence duration.