Usage Of OCTA In Anti-VEGF Treatment Of Choroidal Neovascularization Secondary To Pathologic Myopia

Purpose:Pathologic myopia is one of three leading causes of blindness all around the world,and neovascularization(CNV)is one of its most severer complications.Intravitreal anti-VEGF injection is the first line treatment for choroidal neovascularization secondary to pathological myopia.OCTA can help to diagnose CNV and show the position,size of CNV no matter whether it is active.This study aims at evaluating the use of OCTA during anti-VEGF treatments.Method:21 eyes of 19 patients who accepted intravitreal anti-VEGF injections in Shandong Provincial Hospital since January Ist,2017 to January Ist,2020 were included in the study.Each patient receives OCT and OCTA examination before and after intravitreal anti-VEGF injections.We compared best corrected visual acuity(BCVA),central rentinal and choroidal thickness,vessel density of superficial and deep layer of retina in macula,the size of foveolar avascular zone(FAZ)before and after surgeries to evaluate the effect of treatments.Result:Of all the patients there were 9 eyes of 9 women and 12 eyes of 10 men.The mean age was 52.57 ± 17.73 years old(range 17-83 years).The mean follow-up period time was 7.05 ± 4.24 months(range 2-20 months).The mean time of injections was 1.77±0.69,among which 7 eyes had 1 injection,11 eyes had 2 injections and 3 eyes had 3 injections.The type of anti-VEGF medicine was decided by both doctors and patients.4 people used lucentis,4 people used aflibercept and 8 people used conbercept.There was 1 person who used lucentis twice and changed to conbercept.The mean BCVA was increased significantly,from 1.05±0.58 logMAR to 0.59±0.44 logMAR(p<0.001).16 eyes(76%)obtained an increase of visual acuity,3 eyes(14%)remained the same level and 2 patients(10%)ended up with decrease of visual acuity.Central retinal thickness reduced from 284.75±24.14?m to 263.87 ± 31.53?m(p<0.05).There was no significant change of choroidal thickness,froml32.63±24.25?m to 132.33 ± 23.39?m(p>0.05).The size of FAZ is 0.268±0.108mm2 before treatments and 0.266±0.094mm2 after them(p>0.05).Vessel density of superficial retinal layer changed from 40.98±7.43%to 39.42±10.2%(p>0.05).Vessel density of deep retinal layer reduced a little,from 40.40±6.75%to 37.49±10.14%(p>0.05)Conclusion:Anti-VEGF injection can be quite helpful for treating myopic CNV.As a harmless and efficient implement,OCTA can quickly show the position,size and vessel density of CNV,helping to increase the correction of diagnosis and to evaluate the effect of anti-VEGF treatments.