Optical coherence tomography angiography in myopic macular neovascularization

Pathologic myopia is a severe sight-threatening disorder complicated with the presence of posterior staphyloma, myopic maculopathy, or vitreomacular interface pathologies. Myopic maculopathy is the most common cause of MNV following age-related macular degeneration in the whole population. It is the most common cause of MNV in the presenile population. The diagnosis of MNV should be based on multimodal imaging. On the other hand, optical coherence tomography angiography is gaining popularity in the clinical course of patients with MNV. Its main advantage over dye angiography is the non-invasive nature. Optical coherence tomography angiography can show myopic MNV with very high sensitivity and specificity. It helps detecting the MNV under retinal hemorrhage. Since the image is not obscured by leakage, the neovascular tissue is depicted briefly with OCTA. According to the appearance, two types of myopic MNV has been described; one has a more regular structure with dense vascular hyperintensity and the other has a loose and disorganized appearance. More research is required to detect a clinical basis for these two types. Another advantage of OCTA is the ability of evaluating choriocapillaris which is supposedly takes part in the pathogenesis of myopic MNV and yet providing quantitative data on flow parameters.