Discerning Between Macular Hemorrhages Due to Macular Neovascularization or Due to Spontaneous Bruch's Membrane Rupture in High Myopia: A Comparative Analysis Between OCTA and Fluorescein Angiography.
High myopia
Idiopathic macular hemorrhages
Myopic macular neovascularization
Optical coherence tomography-angiography
Journal
Ophthalmology and therapy
ISSN: 2193-8245
Titre abrégé: Ophthalmol Ther
Pays: England
ID NLM: 101634502
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
03
01
2022
accepted:
07
02
2022
pubmed:
21
2
2022
medline:
21
2
2022
entrez:
20
2
2022
Statut:
ppublish
Résumé
To evaluate the sensitivity and specificity of optical coherence tomography angiography (OCTA) in comparison to fluorescein angiography (FA) in discerning between macular hemorrhages due to myopic macular neovascularization (m-MNV) and idiopathic macular hemorrhage (IMH) in patients with high myopia (HM). In this retrospective study, 14 eyes of 14 patients (mean age 60 ± 16 years) affected by macular hemorrhage due to HM were included. All patients underwent OCTA and FA at the time of macular hemorrhage (i.e., baseline) and were followed for a 3-month follow-up. By means of FA, 8 out of 14 eyes with macular hemorrhage (57%) were diagnosed as type 2 m-MNV, whereas 6 eyes (43%) were diagnosed as IMH. Interestingly, OCTA displayed the presence of a neovascular network in all cases previously diagnosed as m-MNV using FA, and also excluded the presence of anomalous flow in all IMH eyes. This accounted for the high sensitivity and specificity of OCTA for m-MNV detection in HM cases with macular hemorrhage. After 3-month follow-up, BCVA improved from 0.39 ± 0.15 to 0.21 ± 0.14 logMAR (p = 0.006) in patients with m-MNV treated by a mean of 2.3 ± 0.9 intravitreal anti-VEGF injections. Conversely, BCVA improved without treatment (from 0.55 ± 0.48 to 0.17 ± 0.08 logMAR, p = 0.112) in patients with IMH. OCTA is able to differentiate with excellent reliability between the presence of m-MNV in patients with HM presenting with a new macular hemorrhage and an IMH. This could be of paramount relevance in the clinical setting for the diagnosis and treatment of patients with HM.
Identifiants
pubmed: 35184253
doi: 10.1007/s40123-022-00484-0
pii: 10.1007/s40123-022-00484-0
pmc: PMC8927552
doi:
Types de publication
Journal Article
Langues
eng
Pagination
821-831Informations de copyright
© 2022. The Author(s).
Références
Ruiz-Medrano J, Montero JA, Flores-Moreno I, Arias L, García-Layana A, Ruiz-Moreno JM. Myopic maculopathy: current status and proposal for a new classification and grading system (ATN). Prog Retin Eye Res. 2019. https://doi.org/10.1016/j.preteyeres.2018.10.005 .
doi: 10.1016/j.preteyeres.2018.10.005
pubmed: 30391362
Curtin BJ, Karlin DB. Axial length measurements and fundus changes of the myopic eye. Am J Ophthalmol. 1971. https://doi.org/10.1016/0002-9394(71)91092-0 .
doi: 10.1016/0002-9394(71)91092-0
pubmed: 5571220
Ohno-Matsui K, Kawasaki R, Jonas JB, et al. International photographic classification and grading system for myopic maculopathy. Am J Ophthalmol. 2015. https://doi.org/10.1016/j.ajo.2015.01.022 .
doi: 10.1016/j.ajo.2015.01.022
pubmed: 26585211
Wong TY, Ohno-Matsui K, Leveziel N, et al. Myopic choroidal neovascularisation: current concepts and update on clinical management. Br J Ophthalmol. 2015. https://doi.org/10.1136/bjophthalmol-2014-305131 .
doi: 10.1136/bjophthalmol-2014-305131
pubmed: 26608027
Ikuno Y, Jo Y, Hamasaki T, Tano Y. Ocular risk factors for choroidal neovascularization in pathologic myopia. Investig Ophthalmol Vis Sci. 2010. https://doi.org/10.1167/iovs.09-3493 .
doi: 10.1167/iovs.09-3493
Querques G, Corvi F, Balaratnasingam C, et al. Lacquer cracks and perforating scleral vessels in pathologic myopia: a possible causal relationship. Am J Ophthalmol. 2015. https://doi.org/10.1016/j.ajo.2015.07.017 .
doi: 10.1016/j.ajo.2015.07.017
pubmed: 26675387
Ohno-Matsui K, Lai TYY, Lai CC, Cheung CMG. Updates of pathologic myopia. Prog Retin Eye Res. 2016. https://doi.org/10.1016/j.preteyeres.2015.12.001 .
doi: 10.1016/j.preteyeres.2015.12.001
pubmed: 26769165
Ren P, Lu L, Tang X, et al. Clinical features of simple hemorrhage and myopic choroidal neovascularization associated with lacquer cracks in pathologic myopia. Graefes Arch Clin Exp Ophthalmol. 2020. https://doi.org/10.1007/s00417-020-04778-6 .
doi: 10.1007/s00417-020-04778-6
pubmed: 32648154
Franqueira N, Cachulo ML, Pires I, et al. Long-term follow-up of myopic choroidal neovascularization treated with ranibizumab. Ophthalmologica. 2011. https://doi.org/10.1159/000333213 .
doi: 10.1159/000333213
pubmed: 22056757
Cheung CMG, Arnold JJ, Holz FG, et al. Myopic choroidal neovascularization: review, guidance, and consensus statement on management. Ophthalmology. 2017. https://doi.org/10.1016/j.ophtha.2017.04.028 .
doi: 10.1016/j.ophtha.2017.04.028
pubmed: 31047618
pmcid: 5241913
Battista M, Borrelli E, Parravano M, et al. OCTA characterisation of microvascular retinal alterations in patients with central serous chorioretinopathy. Br J Ophthalmol. 2019. https://doi.org/10.1136/bjophthalmol-2019-315482 .
doi: 10.1136/bjophthalmol-2019-315482
Carnevali A, Sacconi R, Querques L, et al. Natural history of treatment-naïve quiescent choroidal neovascularization in age-related macular degeneration using OCT angiography. Ophthalmol Retin. 2018. https://doi.org/10.1016/j.oret.2018.02.002 .
doi: 10.1016/j.oret.2018.02.002
Carnevali A, Capuano V, Sacconi R, et al. OCT angiography of treatment-naïve quiescent choroidal neovascularization in pachychoroid neovasculopathy. Ophthalmol Retin. 2017. https://doi.org/10.1016/j.oret.2017.01.003 .
doi: 10.1016/j.oret.2017.01.003
Sacconi R, Battista M, Borrelli E, et al. OCT-A characterisation of recurrent type 3 macular neovascularisation. Br J Ophthalmol. 2020. https://doi.org/10.1136/bjophthalmol-2020-316054 .
doi: 10.1136/bjophthalmol-2020-316054
pubmed: 32920528
Sacconi R, Sarraf D, Garrity S, et al. Nascent type 3 neovascularization in age-related macular degeneration. Ophthalmol Retin. 2018. https://doi.org/10.1016/j.oret.2018.04.016 .
doi: 10.1016/j.oret.2018.04.016
Sacconi R, Tomasso L, Corbelli E, et al. Early response to the treatment of choroidal neovascularization complicating central serous chorioretinopathy: a OCT-angiography study. Eye. 2019. https://doi.org/10.1038/s41433-019-0511-2 .
doi: 10.1038/s41433-019-0511-2
pubmed: 31767968
pmcid: 7002675
Gong J, Yu S, Gong Y, Wang F, Sun X. The diagnostic accuracy of optical coherence tomography angiography for neovascular age-related macular degeneration: a comparison with fundus fluorescein angiography. J Ophthalmol. 2016. https://doi.org/10.1155/2016/7521478 .
doi: 10.1155/2016/7521478
pubmed: 28025620
pmcid: 5153472
Kedhar SR, Thorne JE, Wittenberg S, Dunn JP, Jabs DA. Multifocal choroiditis with panuveitis and punctate inner choroidopathy: comparison of clinical characteristics at presentation. Retina. 2007. https://doi.org/10.1097/IAE.0b013e318068de72 .
doi: 10.1097/IAE.0b013e318068de72
pubmed: 18046221
Huang Y, Gangaputra S, Lee KE, et al. Signal quality assessment of retinal optical coherence tomography images. Invest Ophthalmol Vis Sci. 2012. https://doi.org/10.1167/iovs.11-8755 .
doi: 10.1167/iovs.11-8755
pubmed: 23139268
pmcid: 3428115
Ohno-Matsui K, Jonas JB. Posterior staphyloma in pathologic myopia. Prog Retin Eye Res. 2019. https://doi.org/10.1016/j.preteyeres.2018.12.001 .
doi: 10.1016/j.preteyeres.2018.12.001
pubmed: 31319157
Ohno-Matsui K, Jonas JB, Spaide RF. Macular bruch membrane holes in highly myopic patchy chorioretinal atrophy. Am J Ophthalmol. 2016. https://doi.org/10.1016/j.ajo.2016.03.019 .
doi: 10.1016/j.ajo.2016.03.019
pubmed: 27365146
Ohno-Matsui K, Ito M, Tokoro T. Subretinal bleeding without choroidal neovascularization in pathologic myopia: a sign of new lacquer crack formation. Retina. 1996. https://doi.org/10.1097/00006982-199616030-00003 .
doi: 10.1097/00006982-199616030-00003
pubmed: 8927806
Giuffrè C, Querques L, Carnevali A, De Vitis LA, Bandello F, Querques G, et al. Choroidal neovascularization and coincident perforating scleral vessels in pathologic myopia. Eur J Ophthalmol. 2017. https://doi.org/10.5301/ejo.5000875 .
doi: 10.5301/ejo.5000875
pubmed: 28708222
Liu B, Zhang X, Mi L, Chen L, Wen F. Long-term natural outcomes of simple hemorrhage associated with lacquer crack in high myopia: a risk factor for myopic CNV? J Ophthalmol. 2018. https://doi.org/10.1155/2018/3150923 .
doi: 10.1155/2018/3150923
pubmed: 30693103
pmcid: 6323471
Parodi MB, Iacono P, Sacconi R, Iuliano L, Bandello F. Fundus autofluorescence changes after ranibizumab treatment for subfoveal choroidal neovascularization secondary to pathologic myopia. Am J Ophthalmol. 2015. https://doi.org/10.1016/j.ajo.2015.04.030 .
doi: 10.1016/j.ajo.2015.04.030
pubmed: 26459982
Leveziel N, Caillaux V, Bastuji-Garin S, Zmuda M, Souied EH. Angiographic and optical coherence tomography characteristics of recent myopic choroidal neovascularization. Am J Ophthalmol. 2013. https://doi.org/10.1016/j.ajo.2012.11.021 .
doi: 10.1016/j.ajo.2012.11.021
pubmed: 23352343
Reichel E, Duker JS, Puliafito CA. Indocyanine green anglography and choroidal neovascularization obscured by hemorrhage. Ophthalmology. 1995. https://doi.org/10.1016/S0161-6420(95)30781-6 .
doi: 10.1016/S0161-6420(95)30781-6
pubmed: 9098290
Miyata M, Ooto S, Hata M, et al. Detection of myopic choroidal neovascularization using optical coherence tomography angiography. Am J Ophthalmol. 2016. https://doi.org/10.1016/j.ajo.2016.03.009 .
doi: 10.1016/j.ajo.2016.03.009
pubmed: 26973049
Bruyère E, Miere A, Cohen SY, et al. Neovascularization secondary to high myopia imaged by optical coherence tomography angiography. Retina. 2017. https://doi.org/10.1097/IAE.0000000000001456 .
doi: 10.1097/IAE.0000000000001456
pubmed: 28590317
Querques L, Giuffrè C, Corvi F, et al. Optical coherence tomography angiography of myopic choroidal neovascularisation. Br J Ophthalmol. 2017. https://doi.org/10.1136/bjophthalmol-2016-309162 .
doi: 10.1136/bjophthalmol-2016-309162
pubmed: 28982952
Spaide RF, Fujimoto JG, Waheed NK, Sadda SR, Staurenghi G. Optical coherence tomography angiography. Prog Retin Eye Res. 2018. https://doi.org/10.1016/j.preteyeres.2017.11.003 .
doi: 10.1016/j.preteyeres.2017.11.003
pubmed: 29229445
Iacono P, Giorno P, Varano M, Parravano M. Structural and optical coherence tomography angiography in myopic choroidal neovascularization: agreement with conventional fluorescein angiography. Eur J Ophthalmol. 2021. https://doi.org/10.1177/1120672119882333 .
doi: 10.1177/1120672119882333
pubmed: 34313159