Perforating scleral vessels adjacent to myopic choroidal neovascularization achieved a poor outcome after intravitreal anti-VEGF therapy

Wangjing Yao; Jiawen Xu; Xiangjun She; Jiangxin Yu; Zhi Liang; Xin Ye; Jiwei Tao; Sulan Wu; Jianbo Mao; Yiqi Chen; Yun Zhang; Lijun Shen

doi:10.3389/fmed.2022.1065397

Perforating scleral vessels adjacent to myopic choroidal neovascularization achieved a poor outcome after intravitreal anti-VEGF therapy

Front Med (Lausanne). 2022 Dec 13:9:1065397. doi: 10.3389/fmed.2022.1065397. eCollection 2022.

Authors

Wangjing Yao¹, Jiawen Xu², Xiangjun She¹, Jiangxin Yu³, Zhi Liang¹, Xin Ye¹, Jiwei Tao¹, Sulan Wu¹, Jianbo Mao⁴, Yiqi Chen⁴, Yun Zhang¹, Lijun Shen^{1

4}

Affiliations

¹ Department of Vitreous and Retinal Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, China.
² Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital, Jiaxing, China.
³ Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No.2 Hospital), Ningbo, China.
⁴ Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China.

Abstract

Background: This study aimed to summarize the features of perforating scleral vessels (PSVs) in patients with myopic choroidal neovascularization (CNV) (mCNV) using optical coherence tomography angiography (OCTA) and to identify the associations with the response after intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy.

Methods: A consecutive series of naïve patients who had mCNV and received intravitreal anti-VEGF therapy with a follow-up duration of 12 months or more were enrolled. The prevalence, location, and branches of PSVs were analyzed. Projection-resolved OCTA (PR-OCTA) was used to analyze the neovascular signals between CNV and PSVs. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured. The proportion of CMT change relative to baseline was used to assess therapeutic response.

Results: A total of 44 eyes from 42 patients with mCNV were enrolled. PSVs were identified in 41 out of 44 eyes. Branches were identified in the PSVs of 24 eyes (57.14%), and 20 eyes did not have PSV branches (47.62%). In eight eyes (18.18%), PSVs were adjacent to mCNV, and in 36 eyes (81.82%), PSVs were not adjacent to mCNV. After anti-VEGF therapy for mCNV, BCVA increased (F = 6.119, p < 0.001) and CMT decreased (F = 7.664, p < 0.001). In the eyes where PSVs were adjacent to mCNV, BCVA improvements (F = 7.649, p = 0.009) were poor, and changes in CMT were small.

Conclusion: The eyes with PSVs adjacent to mCNV showed poor therapeutic responses after intravitreal anti-VEGF therapy.

Keywords: anti-VEGF therapy; choroidal neovascularization; optical coherence tomography; pathological myopia; perforating scleral vessel.