Characterizing Macular Neovascularization in Myopic Macular Degeneration and Age-related Macular Degeneration using Swept Source OCT Angiography

Abstract

Purpose : To describe and compare macular neovascularization (MNV) associated with myopic macular degeneration (MMD) and age-related macular degeneration (AMD) using swept-source optical coherence tomography angiography (SS-OCTA).

Methods : Adult patients with documented MNV were recruited in this cross-sectional study and imaged using 6 x 6 mm angiograms on SS-OCTA. Several qualitative and quantitative features of MNV were assessed, including the MNV area and vessel density (VD). Descriptive statistics and linear regression analyses were carried out.

Results : A total of 75 eyes with MNV, including 30 eyes with MMD-MNV and 45 eyes with AMD-MNV, were considered in this study. Mean subjects’ age in each group was 55 ± 19 years and 75 ± 8 years respectively. The MMD-MNV group exhibited three-fold smaller sized MNV (p=0.001), lower greatest linear dimension (GLD) (p=0.009) and greatest vascular caliber (GVC) (p<0.001) compared to AMD-MNVs, and had a higher prevalence of tree-in-bud pattern. Eyes with AMD showed a higher prevalence of type 1 MNVs with medusa pattern, and tended to have better defined margins with the presence of peripheral loops. There was no difference in the location of the MNV, the shape’s regularity, the presence of a core vessel, a capillary fringe or a perilesional dark halo between both conditions (all p>0.05). MMD-MNV presented a significantly high proportion (59%) of non-discernable MNV on SS-OCTA in our cohort. After adjustment, decreased MNV area and increased VD were associated with the tree-in-bud pattern, whereas the diagnosis did not significantly influence those parameters.

Conclusions : This study is the first to describe and compare MMD-MNV and AMD-MNV using SS-OCTA, providing relevant insight on MNV secondary to MMD and AMD, and further validating OCTA as a powerful tool to detect and characterize MNV non-invasively.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.