Video Color OCT Angiography for Myopic Choroidal Neovascularization

Abstract

Purpose: To investigate the myopic macular neovascularization (mMNV) features on dynamic video color OCT angiography (OCTA) and the diagnostic rate versus the static, 4-segmentations visualization mode.

Design: Retrospective cohort study.

Participants: Fifty-four patients with mMNV.

Methods: Sixty-two eyes with high myopia complicated by mMNV were included. Clinical charts, fluorescein angiography, and structural OCT were used as standard references to assess lesion activity. Static and video color OCTA were then analyzed and compared by 2 independent reviewers.

Main outcome measures: Morphology description of mMNV on video color OCTA and differences in the proportion of diagnosis between video color and static OCTA.

Results: Sixty-two eyes from 54 patients (mean age, 63.22 years) were enrolled. Thirty-four (55%) mMNVs were active and 28 (45%) inactive. Twenty-two (65%) active mMNVs presented on video color OCTA as an interlacing vascular network in the outer retina and the choriocapillaris. A tapered form was the prevalent size (72.7%). In 3 eyes (9%), an abnormal and irregular vascular network (AVN) was disclosed and in 5 (15%) only some blood flow alteration. All the lesions extended in both the outer retina and the choriocapillaris. Eleven (39%) inactive mMNVs also presented on video color OCTA as an interlacing vascular network in the outer retina and the choriocapillaris. Eight (29%) inactive mMNVs had some AVN, and 6 (21%) only some blood flow alteration. The diagnostic rate of video color versus static OCTA was 95% (95% confidence interval [CI], 86%-99%) versus 77% (95% CI, 86%-99%; P = 0.0009), and showed an advantage in favor of video color OCTA of 15% (95% CI, 3%-27%) and 22% (95% CI, 7%-38%) in active and inactive lesions, respectively (P < 0.026). Lesion extension within both the outer retina and the choriocapillaris was present in 90% and 69% of cases on dynamic OCTA and static OCTA, respectively, with a proportion difference of 20% (95% CI, 10%-31%; P = 0.0005). Concordance between the 2 examiners was high: 0.95 (95% CI, 0.88-1.00) and 0.96 (95% CI, 0.91-1.00) for active and inactive lesions, respectively.

Conclusions: Video color-enhanced OCTA may help in diagnosing mMNV and should be considered in addition to structural OCT and static OCTA.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Keywords: CNV; Myopia; OCT angiography; OCTA; Videocolor OCTA.