• Battaglia ParodiMaurizioM*Department of Ophthalmology, Ospedale San Raffaele, University Vita-Salute, Milano, Italy; and †Fondazione G.B. Bietti Foundation for Study and Research in Ophthalmology, IRCCS, Rome, Italy., Pierluigi Iacono, and Francesco Bandello.
• *Department of Ophthalmology, Ospedale San Raffaele, University Vita-Salute, Milano, Italy; and †Fondazione G.B. Bietti Foundation for Study and Research in Ophthalmology, IRCCS, Rome, Italy.
• Retina (Philadelphia, Pa.). 2016 Jan 1; 36 (1): 104-9.

PurposeTo describe the morphologic alterations on spectral domain optical coherence tomography in active myopic choroidal neovascularization (CNV) receiving intravitreal bevacizumab and to evaluate its diagnostic accuracy, taking fluorescein angiography as a reference examination.MethodsThirty patients (30 eyes) were prospectively enrolled. Each eye was imaged with fluorescein angiography and spectral domain optical coherence tomography at the baseline and at 1-, 2-, and 3-month examinations. Spectral domain optical coherence tomography parameters consisting of intraretinal/subretinal fluid and absence of external limiting membrane (ELM) visibility were considered signs of CNV activity and collated with the presence/absence of leakage on fluorescein angiography. Main outcome measures were frequencies of the retinal alterations associated with myopic CNV at the diagnosis and during monitoring of anti-vascular endothelial growth factor therapy.ResultsAt the diagnosis, spectral domain optical coherence tomography identified subretinal fluid in 14 eyes (46%), intraretinal fluid associated with subretinal fluid in 12 eyes (40%), and absence of ELM visibility in 30 of the 30 eyes (100%). During the follow-up, fluorescein leakage was noted in 32 visits (18, 8, and 6 eyes at the 1-, 2- and 3-month examinations, respectively). Taking into consideration spectral domain optical coherence tomography features of active myopic CNVs on fluorescein angiography, subretinal fluid was identified in 24 examinations (75%), intraretinal cysts with subretinal fluid were noted in 5 visits (15.6%), and the absence of ELM visibility was visible in 32 examinations (100%). The alterations of the ELM corresponded to the location of the fluorescein leakage.ConclusionThis study provides evidence that the absence of ELM visibility is a more reliable parameter for evaluating CNV activity than intraretinal/subretinal fluid collection and may constitute a useful option in diagnosing and monitoring the myopic CNV during anti-vascular endothelial growth factor therapy.

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