Optical Coherence Tomography imaging of perforating scleral vessels and dilated choroidal veins as potential image markers in myopic choroidal neovascularization using optical coherence tomography angiography.

Abstract

Introduction: To analyze the role of perforating scleral vessel (PSV) and dilated choroidal veins (DCV) underneath macular myopic choroidal neovascularization (mCNV).

Methods: This retrospective case-control study analyzed 78 eyes from 78 highly myopic patients defined by an axial length (AL) of ≥26 mm, assessed by optical coherence tomography (OCT) and OCT-angiography (OCTA) imaging. Patients with clinical diagnosis of mCNV and good-quality OCTA images were selected. Swept source (SS)-OCT and SS-OCTA images (TRITON; Topcon Corporation, Tokyo, Japan) were reviewed to detect image markers in the mCNV area. Highly myopic eyes without mCNV, matched by age and AL, were used as control group. The presence of PSV and DCV were recorded. Myopic maculopathy was graded using the ATN (Atrophic, Traction and Neovacularization) classification.

Results: 78 eyes from 78 patients (39 with mCNV and 39 without mCNV) were included, out of the total 775 eyes screened. Fifty-nine (75.6%) of them were women. The mean ATN grading of myopic-maculopathy was compared between eyes with mCNV and those without mCNV: Atrophy scores were 2.71±0.97 vs. 2.30±0.89, respectively (p=0.04); Traction scores were 0.64±0.66 vs. 0.84±0.98, respectively (p=0.54); and Neovascularization scores were 2.00±0.00 vs. 0.33±0.73, respectively (p<0.001). The presence of OCT-imaging markers did not significantly differ between groups; i.e., PSV was found in 34/39 vs. 32/39 (p=0.53) eyes and DCV was found in 11/39 vs. 7/39 eyes, mCNV vs. control group respectively (p=0.28).

Conclusions: PSV and DCV are image markers present in a high number of highly myopic eyes, which are not specific to mCNV.