Role of Dilated Subfoveal Choroidal Veins in Eyes With Myopic Macular Neovascularization

Xie, Shiqi; Fang, Yuxin; Du, Ran; Onishi, Yuka; Yokoi, Tae; Moriyama, Muka; Watanabe, Takashi; Ohno‐Matsui, Kyoko

doi:10.1097/iae.0000000000002970

Cited by 12 publications

(20 citation statements)

References 22 publications

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“…To date, this feature has been exclusively reported in this condition. In two studies, Xie et al reported that a dilated choroidal vein was correlated with the occurrence 20 and the recurrence 19 of MNVs. Moriyama et al 18 also showed a HM eye that developed MNV just over a dilated choroidal vein.…”

Section: Discussionmentioning

confidence: 99%

“…17 In addition to the extreme thinning, the remaining large choroidal veins were reported to have marked changes in PM eyes. 18–20 These studies used mainly the 50° ICGA indocyanine green angiography (ICGA) images, and to date, there are limited data on how the choroidal vasculature is altered over the entire fundus in a large population of PM eyes. Therefore, in the present study, we used widefield ICGA (WF-ICGA) to explore choroidal venous remodeling patterns in the entire fundus, so as to unravel the mechanisms of remodeling and their clinical implications.…”

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confidence: 99%

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Anomalies of Choroidal Venous Structure in Highly Myopic Eyes

Xie

et al. 2022

Retina

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Purpose: To identify anomalies of choroidal venous structure in highly myopic (HM) eyes.Methods: Widefield indocyanine green angiographic images of 175 HM eyes (refractive error # -6.0D diopters or axial length .26.5 mm) and 100 control eyes taken between January 2014 and December 2018 were reviewed.Results: There were no significant differences in age and gender between HM patients and controls. Three types of changes of large choroidal veins were found in 103 HM eyes (58.86%): Asymmetry of vortex veins in 44 eyes (25.14%), isolated long vein across the macula in 58 eyes (33.14%), and intervortex anastomoses in 25 eyes (14.29%). Similar changes in controls were found in 12 eyes (12%), 0 eye (0%), and 2 eyes (2%), respectively, which were significantly lower than those in the HM group (all P , 0.05). The patterns of asymmetry were affected by steeper staphyloma edges and anastomoses were observed through large trunks and terminal venules. In two eyes with large trunk anastomosis, attenuation of the less dominant vortex vein was observed afterward.Conclusion: Choroidal venous anomalies are more common in HM eyes than controls. Choroidal venous structure in HM eyes may be altering continuously, and such changes may underlie the development of myopic maculopathy.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Anomalies of Choroidal Venous Structure in Highly Myopic Eyes

Xie

et al. 2022

Retina

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“…More recently, the same group reported the presence of dilated subfoveal choroidal veins (DCVs) below or around the neovascular complex in 30% of the eyes with mCNV. 30 The authors suggested that mCNV receive the flow from the SPCA and drain to the dilated subfoveal choroidal veins. They stated that SPCAs are filled first, followed by mCNV, which then drain to the dilated subfoveal choroidal veins, and talked about the possible role that chronic choroidal venous congestion may play on the development of mCNV in eyes with PM.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Myopic Choroidal Neovascularization Activity and Perforating Scleral Vessels in High Myopia

Ruiz‐Medrano

Almazán-Alonso

Flores‐Moreno

et al. 2022

Retina

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To study perforating scleral vessels (PSVs) in patients with high myopia using swept-source optical coherence tomography and to determine their relationship with myopic choroidal neovascularization (mCNV) and its activity.Methods: Retrospective analysis of patients with high myopia ($26 D or $26 mm of axial length) using multimodal imaging. The presence of PSVs and mCNV was assessed using swept-source optical coherence tomography images (TRITON; Topcon Corporation, Japan).Results: Five hundred sixty-four eyes from 297 highly myopic patients were studied. One hundred fifty-five eyes (27.5%) showed signs of mCNV while PSVs were found in 500 eyes (88.6%). Perforating scleral vessels were found in 93.5% (145/155) of eyes with mCNV, and they were under or in contact with the mCNV in 80.6% (117/145). The mean number of intravitreal injections received by patients with mCNV was 4.06 ± 4.17 along 66.9 ± 4.1 months of follow-up. The number of injections per year was 1.32 ± 1.56, the mean number of relapses was 1.11 ± 1.83, and the mean number of relapses per year was 0.25 ± 0.41. Conclusion:Perforating scleral vessels are more common among highly myopic patients suffering from neovascular complications. Myopic CNV complexes that are coincident with PSVs on optical coherence tomography show higher rates of activity, needing more injections to control them and being more prone to relapses.

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“…However, shadows do not always appear. For instance, Xie et al 30 recently reported that a dilated choroidal vein beneath CNV was observed in 30% of mCNV eyes. One mechanism underlying the CFD around CNV might be choriocapillaris exclusion by the choroidal vein.…”

Section: Discussionmentioning

confidence: 99%

Association between choriocapillaris flow deficit and choroidal neovascularization activity in eyes with myopic choroidal neovascularization

Uematsu

Sakaguchi

Sayanagi

et al. 2021

Preprint

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Although choriocapillaris flow deficit (CFD) around choroidal neovascularization (CNV) is less associated with CNV activity in myopic eyes, there are no reports investigating its size as an indicator of CNV activity. We investigated the relationship between CFD and high myopia-related CNV. In this retrospective, observational study, patients underwent optical coherence tomography angiography (OCTA) with split-spectrum amplitude decorrelation angiography for diagnosing pathological myopic CNV (mCNV); CFD features around CNV margins were evaluated. Of the 33 eyes (30 patients), 11 (33.3%) had active mCNV, and 22 (66.7%) had inactive CNV. Five eyes (15.2%) were treatment-naïve, while the remainder previously underwent anti-vascular endothelial growth factor therapy. On OCTA, blood flow signals were detected in CNV in the outer retinal layer in 28 (84.8%) eyes, including all active cases (11 cases) and 17 (77.3%) of 22 inactive cases. CNV flow signal size correlated significantly with activity (P = 0.002). CFD around CNV was observed in 18 eyes (54.5%), eight of which had active CNV. CFD size correlated significantly with CNV activity (P = 0.014). The size of both the CFD area around CNV and CNV flow signal area are useful indicators of CNV activity in eyes with mCNV, which may help determine treatment timing.

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Role of Dilated Subfoveal Choroidal Veins in Eyes With Myopic Macular Neovascularization

Cited by 12 publications

References 22 publications

Anomalies of Choroidal Venous Structure in Highly Myopic Eyes

Anomalies of Choroidal Venous Structure in Highly Myopic Eyes

Relationship Between Myopic Choroidal Neovascularization Activity and Perforating Scleral Vessels in High Myopia

Association between choriocapillaris flow deficit and choroidal neovascularization activity in eyes with myopic choroidal neovascularization

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