Ruiz-Medrano Jorge, Almazán-Alonso Elena, Puertas Mariluz, Flores-Moreno Ignacio, García-Zamora María, Kudsieh Bachar, Ruiz-Moreno José M
Department of Ophthalmology, Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain.
Ocular Microsurgery Institute IMO, Madrid, Spain.
Ophthalmologica. 2025;248(3):160-167. doi: 10.1159/000544750. Epub 2025 Feb 18.
The aim of the study was to analyze the role of perforating scleral vessel (PSV) and dilated choroidal veins (DCVs) underneath macular myopic choroidal neovascularization (mCNV).
This retrospective case-control study analyzed 78 eyes from 78 highly myopic patients defined by an axial length (AL) of ≥26 mm, assessed by optical coherence tomography (OCT) and OCT angiography (OCTA) imaging. Patients with clinical diagnosis of mCNV and good-quality OCTA images were selected. Swept source (SS)-OCT and SS-OCTA images (Triton; Topcon Corporation, Tokyo, Japan) were reviewed to detect image markers in the mCNV area. Highly myopic eyes without mCNV, matched by age and AL, were used as control group. The presence of PSV and DCV was recorded. Myopic maculopathy was graded using the atrophic, traction, and neovascularization (ATN) classification.
Seventy-eight eyes from 78 patients (39 with mCNV and 39 without mCNV) were included, out of the total 775 eyes screened. Fifty-nine (75.6%) of them were women. The mean ATN grading of myopic maculopathy was compared between eyes with mCNV and those without mCNV: atrophy scores were 2.71 ± 0.97 versus 2.30 ± 0.89, respectively (p = 0.04); traction scores were 0.64 ± 0.66 versus 0.84 ± 0.98, respectively (p = 0.54); and neovascularization scores were 2.00 ± 0.00 versus 0.33 ± 0.73, respectively (p < 0.001). The presence of OCT imaging markers did not significantly differ between groups; i.e., PSV was found in 34/39 versus 32/39 (p = 0.53) eyes, and DCV was found in 11/39 versus 7/39 eyes, mCNV versus control group, respectively (p = 0.28).
PSV and DCV are image markers present in a high number of highly myopic eyes, which are not specific to mCNV.
本研究旨在分析黄斑部近视性脉络膜新生血管（mCNV）下方的穿通性巩膜血管（PSV）和扩张的脉络膜静脉（DCV）的作用。
本回顾性病例对照研究分析了78例高度近视患者的78只眼，这些患者的眼轴长度（AL）≥26mm，通过光学相干断层扫描（OCT）和OCT血管造影（OCTA）成像进行评估。选择临床诊断为mCNV且OCTA图像质量良好的患者。回顾扫频源（SS）-OCT和SS-OCTA图像（Triton；日本东京拓普康公司），以检测mCNV区域的图像标志物。将年龄和AL相匹配的无mCNV的高度近视眼作为对照组。记录PSV和DCV的存在情况。使用萎缩、牵拉和新生血管形成（ATN）分类法对近视性黄斑病变进行分级。
在总共筛查的775只眼中，纳入了78例患者的78只眼（39例有mCNV，39例无mCNV）。其中59例（75.6%）为女性。比较了有mCNV的眼和无mCNV的眼的近视性黄斑病变的平均ATN分级：萎缩评分分别为2.71±0.97和2.30±0.89（p=0.04）；牵拉评分分别为0.64±0.66和0.84±0.98（p=0.54）；新生血管形成评分分别为2.00±0.00和0.33±0.73（p<0.001）。两组之间OCT成像标志物的存在情况无显著差异；即，PSV在34/39只眼中被发现，而对照组为32/39只眼（p=0.53），DCV在有mCNV的39只眼中有11只被发现，对照组为7/39只眼（p=0.28）。
PSV和DCV是大量高度近视眼中存在的图像标志物，并非mCNV所特有。
