The Neovascular Signal of Myopic Choroidal Neovascularization from Perforating Scleral Vessel Prone to Recur after Anti-VEGF therapy

Abstract Objectives: To analyzed the recurrence of myopic choroidal neovascularization (mCNV) based on the neovascular signal from perforating scleral vessel (PSV) by optical coherence tomography angiography (OCTA) after anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods:A consecutive series of naïve patients with mCNV accepted anti-VEGF therapy with a minimum 12-month follow-up period. The location of PSV with CNV were classified into PSV adjacent to CNV or not by B scan and the flow signal of CNV was classified into the neovascular signal of CNV from PSV or not by OCTA. The recurrence of mCNV in various PSV with CNV types were compared. K-M survival and Cox proportional hazard model analysis were used to identify risk factors associated with recurrence of mCNV. Results: PSVs were found in 59 of 63 eyes (93.7%) with mCNV in the macular region. The eyes with presence of neovascular signal of CNV from PSV were detected 25 eyes (39.7%). The overall mCNV recurrence rate was 46.0% (29/63) during the follow-up period. According to K-M analysis, the presence of neovascularization with mCNV from PSV predicted a higher recurrence of 60% and a shorter recurrent duration (χ2 =4.486, P=0.034). The Cox proportional hazard model demonstrated that the presence of neovascularization with mCNV from PSV was an independent risk factor for recurrence (HR: 2.19, 95%Cl 1.04-4.62). Conclusions:PSV was mainly detected with mCNV. When the neovascularization of the mCNV comes from PSV, it has a greater recurrence rate with a shorter recurrence duration.