Dilated choroidal veins and their role in recurrences of myopic macular neovascularisations

Br J Ophthalmol. 2022 Oct;106(10):1429-1435. doi: 10.1136/bjophthalmol-2021-318970. Epub 2021 Apr 28.

Abstract

Aim: To determine whether there is a correlation between the presence of macular dilated choroidal vein (DCV) and the recurrence of myopic macular neovascularisation (MNV) after antivascular endothelial growth factor (VEGF) treatment.

Methods: Medical records of 168 eyes of 163 patients with myopic MNV were reviewed for the presence of macular DCV and episodes of recurrences. A macular DCV was defined as a choroidal vein whose diameter was 2× larger than the adjacent veins coursing in the macular area of 5.5 mm diameter.

Results: Macular DCV existed in 47 (28%) of the eyes with myopic MNV. 70 eyes (41.7%) had recurrence during a mean follow-up period of 52.5±23.0 months. Recurrence was found in 28 of the 47 eyes (59.6%) with DCV, which was significantly more frequent than the 42 of the 121 eyes (34.7%) without DCV (p=0.003). Cox model analysis showed that macular DCV was an independent risk factor (HR: 2.0, 95% CI 1.1 to 3.5) for recurrence. The recurrence rate was significantly higher in eyes with DCV within the first 2 years after the onset than in eyes without DCV.

Conclusions: Macular DCVs may be indicators of a more aggressive phenotype of eyes with myopic MNV. These eyes need careful monitoring after anti-VEGF therapies.

Keywords: choroid; imaging; macula; neovascularisation; retina.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Choroid / blood supply
  • Choroidal Neovascularization* / diagnosis
  • Choroidal Neovascularization* / drug therapy
  • Choroidal Neovascularization* / etiology
  • Endothelial Growth Factors
  • Fluorescein Angiography
  • Humans
  • Myopia* / complications
  • Retrospective Studies
  • Tomography, Optical Coherence

Substances

  • Endothelial Growth Factors