Multimodal imaging and diagnosis of myopic choroidal neovascularization in Caucasians.
OBJECTIVE
To investigate myopic choroidal neovascularization (mCNV) by fluorescein angiography (FA), spectral-domain optical coherence tomography (SD-OCT), near-infrared (NIR) reflectance, and autofluorescence (AF).


METHODS
This retrospective study included 65 eyes of 62 Caucasian patients with a mean age of 66.72 years (95% confidence interval [CI] 63-70 years) and a mean refraction of -9.72 diopters (95% CI -8.74 to -10.70 diopters).


RESULTS
Most of the mCNV cases were foveal-juxtafoveal (60/65, 92.3%), with thickening of the corresponding retina (62/65, 95.3%) and leakage on FA (44/65, 67.6%). No retinal fluid was detectable in 32 (49.2%) eyes and there was no hemorrhage in 25 (38.4%) eyes. Papillary chorioretinal atrophy was evident in 58 (89.2%), a shadowing effect in 48 (73.8%), and an epiretinal membrane in 38 (58.4%) eyes. If an area of macular chorioretinal atrophy was present, mCNV frequently developed adjacent to it and was hyperfluorescent rather than with leakage (P⩽0.001). In eyes with edema or hemorrhage, hyper-reflective foci were more frequent (P⩽0.005). NIR and AF features were indeterminable in 19 (29.2%) and 27 (41.5%) eyes, respectively. The predominant feature was black or grayish on NIR (34/65, 52.3%) and patchy (hypo- and hyperfluorescence was observed) on AF (25/65, 38.4%). FA and SD-OCT correctly detected mCNV in 49 (75.3%) and 48 (73.8%) eyes, respectively, whereas NIR and AF exhibited limited diagnostic sensitivity. Doubtful diagnosis was associated with hyperfluorescent mCNV (P⩽0.001), absence of retinal fluid and epiretinal membrane (P⩽0.05), and presence of macular chorioretinal atrophy (P⩽0.01).


CONCLUSIONS
Tomographic, angiographic, AF, and NIR features of mCNV are described in this study. Combination of SD-OCT and FA is recommendable for diagnosis.
Ophthalmology Department, Istituto Auxologico.
Paolo
P
Milani
Ophthalmology Department, Istituto Auxologico.
Amedeo
A
Massacesi
Ophthalmology Department, Istituto Auxologico.
Stefania
S
Moschini
Ophthalmology Department, Istituto Auxologico.
Marco
M
Setaccioli
Ophthalmology Department, Istituto Auxologico.
Ennio
E
Bulone
Ophthalmology Department, Istituto Auxologico.
Gemma
G
Tremolada
Ophthalmology Department, Istituto Auxologico.
Stefano
S
Ciaccia
Ophthalmology Department, Istituto Auxologico.
Elena
E
Mantovani
Institute of Mathematics, Universita' degli Studi di Milano, Milan, Italy.
Daniela
D
Morale
Ophthalmology Department, Istituto Auxologico.
Fulvio
F
Bergamini
CNV; SD-OCT; fluorescein angiography; imaging; myopic neovascularization; pathologic myopia
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