Neovascularization Secondary to High Myopia Imaged by Optical Coherence Tomography Angiography

Abstract

The OCTA seems to be a valuable tool in detecting myopic CNV with a high sensitivity. However, its specificity needs to be investigated in further studies.

Optical coherence tomography angiography reproducibility of lesion size measurements in neovascular age-related macular degeneration (AMD)

“…Furthermore, our group has previously used the 30-micron manual segmentation in multiple studies16; as we have observed, it allowed a more precise delineation of the neovascular membrane than automatic outer retinal or choriocapillaris segmentations. Precisely, the upper boundary of this segmentation is on the Bruch’s membrane, while its lower boundary is situated 30 microns underneath.…”

Optical coherence tomography angiography features of choroidal neovascularization secondary to angioid streaks

“…The delay between the actual presence of CNV and visual loss explains why CNVs secondary to AS have a larger area than type 2 CNV associated with AMD, given that the latter begins more often in the retro or juxta-foveolar region (mean 2.24 mm 2 in AS versus 0.25 mm 2 in AMD) [30,31]. Concerning Type 2 CNV complicating pathologic myopia, although CVN size is much smaller (0.34 mm 2 ), the delay between CNV formation and vision loss is shorter, as these new vessels tend to appear in the (peri)foveolar region, generating symptoms quite quickly [32].…”

Imaging in Myopia

“…A feature of pathological myopia, retinal avascularity in the 360° of the periphery, can also be revealed using wide-field FFA [81]. Distinguishing the myriad causes of subretinal exudation in high myopes (i.e., simple lacquer crack hemorrhage, inflammatory lesions, and mCNV [82,83]) can be achieved with OCTA, which has the ability to identify neovascular membranes noninvasively. However, FFA remains the gold standard for mCNV diagnosis, given OCTA's comparatively lower sensitivity [84].…”

“…However, FFA remains the gold standard for mCNV diagnosis, given OCTA's comparatively lower sensitivity [84]. Furthermore, FFA is still necessary for monitoring disease activity, as OCTA lacks the ability to discern disease activity-where the flow signal may persist in an inactive mCNA [83][84][85]. Still, OCTA can assist with distinguishing the stages of mCNV via identification of signs of activity.…”