[Optical coherence tomography angiography in the diagnosis of myopic choroidal neovascularization]

Purpose - to perform a complex assessment of the retina and choroid in patients with pathological myopia (PM) complicated by subretinal neovascularization, and to determine the changes that govern the development of myopic subretinal neovascular membrane (SNM).

The study examined 48 patients (40 females, 8 males) aged 18 to 54 years with pathological myopia complicated by SNM. All patients underwent standard ophthalmological examination including optical coherence tomography (OCT).

Myopic SNM was detected in 56 eyes of 48 examined PM patients (the process was bilateral in eight patients). A pronounced increase in the axial eye length was accompanied by extreme thinning of the choroid, dystrophic changes in the posterior pole, and decreased visual acuity. In 20% of cases (11 eyes), the disease was detected during its active phase, in 37.5% (21 eyes) - scarring stage, in 43% (27 eyes) - atrophy stage. The blood flow inside the membranes was recordable at all stages of the pathological process. Perforating intrascleral vessels that communicate with neovascular membranes could be seen in all patients. The filling-up of these vessels with contrast in the early arterial phase of fluorescein angiography (FA) suggests that they are the branches of the short posterior ciliary arteries (SPCA).

The key link in the pathogenesis of myopic SNM is pathological arteriogenesis, in which the branches of the SPCA are the source of the formation of neovascular membranes.