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Laura Dell'Arti, Diego Vezzola, Giulio Barteselli, Chiara Mapelli, Eleonora Benatti, Francesco Viola, Roberto Ratiglia; Spectral-domain optical coherence tomography imaging of the retinal pigment epithelium in myopic choroidal neovascularization. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3613.
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To analyze the retinal pigment epithelium (RPE) appearance of inactive myopic choroidal neovascularization (CNV) with spectral-domain optical coherence tomography (SD-OCT) and to evaluate its association with the lesion size and the treatment duration.
We retrospective reviewed imaging studies of eyes with inactive myopic CNV after successful treatment. Imaging included infrared reflectance (IR), fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography, and spectral-domain optical coherence tomography (SD-OCT). Patients were divided into two groups. Group 1 showed uniformity of the RPE (defined as continuous and highly reflective layer on SD-OCT) over the CNV, while group 2 showed an irregular RPE (defined as disrupted and poorly reflective layer on SD-OCT). The presence of perilesional hyper-reflective ring (PHR) in IR imaging was determined; the major diameter (MajD), the minor diameter (MinD) and the area of the lesion (A2) in early FA images were measured using the built-in caliper of the SD-OCT device. The number of treatments performed before CNV stabilization was assessed for every patient.
Eighty-one eyes of 72 patients were included. Group 1 and group 2 included 27 and 54 eyes, respectively. MajD, MinD and A2 of the CNVs were significantly lower in group 1 than in group 2 (p<0.001). Group 2 patients needed greater number of treatments than group 1 patients (p<0.01). The presence of a PHR was detected more frequently in group 1 than in group 2 (p<0.01). Binary regression analysis showed that the only predictor for the presence of a uniform RPE after successful treatment was the size of the CNV. Conditional selection of variables showed that the best regression model for the presence of a regular RPE after successful treatment included size of the lesion and presence of the PHR.
The uniformity of RPE and the presence of PHR turned out to be good prognostic factors for myopic CNVs. Size of myopic CNV influences the development of a uniform RPE over the lesion and, consequently, can condition the prognosis of the disease.
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