Optical coherence tomography angiography of myopic choroidal neovascularization treated by anti-VEGF therapy

Background: To analyze the efficiency of anti-vascular endothelial growth factor (anti-VEGF) therapy for myopic choroidal neovascularization (CNV) by optical coherence tomography angiography (OCTA) and to determine the reduction ratio of CNV lesions after anti-VEGF therapy. Methods: A total of 41 patients (41 eyes) with myopic CNV who were treated with anti-VEGF were included in the study. The best corrected visual acuity (BCVA), superficial vessel density, deep vessel density, the area of foveal avascular zone (FAZ), central macular thickness (CMT) and the area and the flow area of CNV lesion at baseline and at the follow-up after 1, 2, 3 and 6 months were measured. Results: After treatment, BCVA improved (F=6.848, P<0.05), while the CMT (F=2.489, P<0.05), the area (F=3.125, P<0.05) and the flow area (F=3.558, P<0.05) of CNV lesion reduced. On the other hand, superficial vessel density, deep vessel density and the area of FAZ had no change. The mean reduction ratio of lesions was 50.32% (7.07% to 100%). Only in two cases, 100% lesion regression was observed (4.88%). There was a negative correlation between the CNV lesion area and reduction ratio (r=–0.380，P=0.042) and the flow lesion area and reduction ratio (r=–0.402, P=0.030). Conclusions: Anti-VEGF therapy is efficient for myopic CNV without affecting superficial vessel density and deep vessel density of retina, but it is unable to completely eliminate CNV lesions in most cases. The mean reduction ratio is 50.32%, and the bigger myopic CNV lesions have a lower reduction ratio.