Detection of Myopic Choroidal Neovascularization Using Optical Coherence Tomography Angiography

Purpose To assess whether optical coherence tomography angiography (OCTA) can be used as an alternative to conventional fundus fluorescein angiography (FFA) for the detection of myopic choroidal neovascularization (CNV) Design Validity and reliability analysis Methods Twenty-eight eyes of 26 consecutive Japanese patients with exudative lesions associated with pathological myopia were included in this institutional study. Myopic CNV was detected in 23 eyes of 22 patients; five eyes exhibited simple hemorrhage. The main outcome measure was CNV detection by OCTA and FFA. The CNV area was individually measured by FFA and OCTA. Intraclass correlation coefficients (ICCs) for the CNV area independently measured by two investigators using OCTA and FFA were determined. Results OCTA images with sufficient quality for CNV assessment were obtained for 17 eyes with CNV and four without. FFA alone detected CNV in all 17 eyes, while OCTA alone detected CNV in 16 (94.1%). The one eye for which CNV was not detected by OCTA exhibited a 0.01-mm2 area on FFA. Both FFA and OCTA did not detect CNV in eyes with simple hemorrhage. The mean CNV areas on FFA and OCTA were 0.59 ± 0.56 and 0.51 ± 0.55 mm2 , respectively; the two values were significantly correlated ( p < .001, r = .86). The ICC (2, 1) values for FFA and OCTA were 0.944 and 0.997, respectively. Conclusions Our results indicate that OCTA can detect most myopic CNVs if high-quality images are acquired and can preclude the requirement for FFA in these setting.