PREDICTING LESION SHRINKAGE IN EYES WITH MYOPIC CHOROIDAL NEOVASCULARIZATION FROM FEATURES ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

Purpose: To identify baseline morphological predictors of lesion shrinkage in eyes with myopic choroidal neovascularization (mCNV) treated with anti-vascular endothelial growth factor. Methods: This retrospective study included 46 eyes (41 consecutive patients) with active mCNV receiving anti-vascular endothelial growth factor treatment. Optical coherence tomography angiography was performed at baseline and 1 year after treatment. Quantitative features were obtained from optical coherence tomography angiography images using AngioTool software. Eyes were classified as high shrinkage or low shrinkage according to the median relative change in lesion area. Baseline quantitative morphological features associated with mCNV shrinkage were identified in univariate and multivariate analyses. Results: The mCNV area was significantly smaller after 1 year (P = 0.013), with a median relative change of -16.5%. The relative change in mCNV area was -48.3% in high-shrinkage eyes (n = 23) and -5.2% in low-shrinkage eyes (n = 23). High-shrinkage eyes had a smaller mCNV area (P = 0.013), shorter total vessel length (P = 0.023), and higher end point density (P < 0.001). Multivariate analysis showed significant associations of high shrinkage with end point density (beta = -0.037, P = 0.043) and previous anti-vascular endothelial growth factor treatment (beta = 0.216, P = 0.029). Conclusion: Morphological features of neovascularization detected by optical coherence tomography angiography can predict lesion shrinkage in eyes with mCNV receiving anti-vascular endothelial growth factor therapy. Higher end point density contributed to shrinkage, particularly of treatment-naive lesions.

Automated summary

This study found that baseline morphological features of myopic choroidal neovascularization (mCNV) can predict the shrinkage of the lesion in eyes treated with anti-vascular endothelial growth factor. Smaller mCNV area, shorter total vessel length, and higher end point density were associated with greater shrinkage. Higher end point density was particularly associated with shrinkage in treatment-naive lesions.