Perforating Scleral Vessels and Their Influence on Myopic Macular Neovascularization

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Myopic macular neovascularization (mMNV) is a leading cause of vision loss in high myopia.
• Understanding the anatomical features associated with mMNV is crucial for predicting disease progression and treatment response.
• Perforating scleral vessels (PSVs) are vascular channels that may play a role in retinal pathologies.

Purpose of the Study:

• To investigate the presence and spatial relationship of PSVs to the neovascular membrane in mMNV using spectral-domain optical coherence tomography (SD-OCT).
• To assess the association of PSVs with clinical, anatomical, and treatment-related features in patients with mMNV.

Main Methods:

• Retrospective case series of patients diagnosed with mMNV from the Portuguese Retina Study Group registry.
• SD-OCT macular scans were reviewed to identify PSVs and their proximity to the neovascular membrane.
• Clinical data, including age, choroidal thickness, macular thickness, and treatment history, were analyzed.

Main Results:

• PSVs were identified in 69% of eyes with mMNV, with 68% in direct contact with the neovascular membrane.
• PSV presence was significantly associated with older age, thinner choroid, and greater macular thickness at diagnosis.
• PSVs were linked to a higher likelihood of anti-VEGF treatment switch but not recurrence or visual acuity changes.

Conclusions:

• PSVs are frequently observed in mMNV and correlate with specific baseline characteristics.
• While PSVs are associated with treatment adjustments, their presence or contact with the lesion does not independently predict disease course or functional outcomes in mMNV.