CHANGES IN MYOPIC MACULOPATHY BASED ON ATN CLASSIFICATION SYSTEM: An Optical Coherence Tomography Angiography Study.

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Myopic maculopathy is a leading cause of vision impairment.
• The ATN classification system aids in categorizing myopic maculopathy.
• Optical coherence tomography angiography (OCTA) allows detailed visualization of choroidal vasculature.

Purpose of the Study:

• To evaluate choroidal changes in myopic maculopathy using OCTA.
• To correlate macular choroidal thickness (MCT) and choriocapillaris flow (CC) with the ATN classification system.

Main Methods:

• Cross-sectional study involving 153 participants (219 eyes).
• OCTA was used to measure MCT and CC.
• Analysis of the relationship between MCT, CC, and grades of atrophy (A), traction (T), and neovascularization (N).

Main Results:

• MCT and CC showed significant negative correlations with atrophy grades (A).
• Choriocapillaris flow decreased with lacquer cracks and increased with active choroidal neovascularization.
• MCT decreased most in early atrophic maculopathy, while CC reduced most in late stages.

Conclusions:

• OCTA detected significant choroidal changes in highly myopic patients.
• Progressive macular ischemia is implicated in myopic atrophic maculopathy.
• Active neovascularization may compensate for reduced choroidal blood flow, whereas traction maculopathy shows minimal correlation with choroidal changes.