Fluorescein Leakage and Optical Coherence Tomography Features of Choroidal Neovascularization Secondary to Pathologic Myopia

Abstract

Different patterns of mCNV may be identified in FA and they correlate with specific SD-OCT alterations. Moreover, the type of FA leakage may assist in identifying more active mCNV.

Structural and optical coherence tomography angiography in myopic choroidal neovascularization: Agreement with conventional fluorescein angiography

“…This is confirmed in both the initial diagnostic phase and during the anti-vascular endothelial growth factor (VEGF) treatment. 6–9 We emphasize, however, that the examination is most reliable only by combining information of all new indicators. The study proves that the fuzzy borders of the mCNV and ELM visibility are the parameters that best help identify the mCNV activity, even compared with SHE.…”

“…The study proves that the fuzzy borders of the mCNV and ELM visibility are the parameters that best help identify the mCNV activity, even compared with SHE. 6,8,9…”

“…This could also explain the rapidity of the recovery of the visibility of ELM and the prompt resolution of the fuzzy border of the mCNV after ranibizumab administration. In addition, mCNVs are generally associated with low exudation and with leakage that appears to be moderate in 35% of cases; 9 low leakage may not be sufficient to produce large intraretinal or subretinal fluid collection or deposits characterizing the SHE. Finally, the central retinal thickness is reduced in myopic eyes with high refractive errors and is inversely proportional to the axial length.…”

“…12,13,15,16 Similarly, we do not think the level of the examiners’ skill may have been a drawback in the methodology, because each examiner had proven experience with mCNV evaluation and management. 3,6,9,17–22 It is important to bear in mind that the eyes with PM have a specific chorioretinal structure, with alterations of the scleral profile, a thinner retina, and different stages of myopic maculopathy, and functional alterations, such as reduced visual acuity or fixation instability, are often present. All these elements can be considered limiting factors for OCT-A technology.…”

“…6–8 Structural OCT provides a better morphological definition of mCNV and identifies the absence of external limiting membrane (ELM) visibility, the presence of blurred mCNV margins, and the accumulation of subretinal hyperreflective exudation (SHE) as new monitoring parameters. 6–9…”