Treatment-naïve quiescent macular neovascularization and pachychoroid neovasculopathy

Abstract

Purpose : Recently, treatment-naïve quiescent macular neovascularization (MNV) is detected on optical coherence tomography angiography (OCTA) without intraretinal or subretinal fluid. On the other hand, pachychoroid neovasculopathy (PNV) with choroidal abnormalities such as choroidal thickening, has been proposed as a new clinical entity. The relationship between quiescent MNV and PNV is not fully understood in detail.
The purpose of this study was to evaluate the choroidal vasculature in quiescent MNV using widefield enface OCT.

Methods : The study subjects were 39 eyes of 38 patients who were diagnosed quiescent MNV with OCTA and able to observe the choroidal vasculature in widefield en face OCT. All subjects were Japanese, and the mean age was 60.6 years (27 males and 11 females).
We diagnosed quiescent MNV using 3×3 mm OCTA (RTVue XR Avanti, Optovue), and evaluated choroidal vasculature with 12×12 mm en face OCT obtained at the same time as the OCTA (Elite9000, Zeiss). PNV was defined with MNV detected just above the dilated choroidal vessels. Subfoveal choroidal thickness (SCT) was also measured with Swept Source OCT (DRI-OCT, Topcon).

Results : All patients had type1 MNV, with a mean visual acuity of 20/20. PNV was detected in 28 of 39 eyes (71.8%). Mean SCT (339±113μm) in PNV was significantly thicker than that (222±113μm) in non-PNV (P＜0.01). During the average follow-up period of 19.3 months, the exudation developed in 12 eyes (30.8%). There were slightly more PNV cases (8 eyes), however the difference was not significant (P=0.71).

Conclusions : Quiescent MNV cases included many cases of PNV, suggesting that choroidal vascular abnormalities are involved in the pathogenesis of the disease.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.