OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES OF SUBRETINAL FIBROSIS AFTER MYOPIC NEOVASCULARIZATION

Purpose: To describe the optical coherence tomography (OCT) angiography features of
subretinal fibrosis in eyes with myopic choroidal neovascularization after natural evolution
or secondary to intravitreal anti–vascular endothelial growth factor therapy.
Methods: Retrospective observational case series. All eyes underwent a multimodal
imaging examination including fluorescein angiography, spectral domain OCT, OCT
angiography, and en face OCT.
Results: Twenty-five eyes of 25 patients with mean age of 56.4 ± 14.9 were included in
the study. Subretinal fibrosis was diagnosed at mean 30 (range 6–116) months before
inclusion. Within the subretinal fibrosis, an abnormal vascular network was observed in
20/25 (80%) eyes, located typically in the outer retina (18/20, 90%) or the choriocapillaris
(14/20, 70%) segmentation. The most prevalent patterns were “round tangle” and “tapered
tangle.” On en face OCT, the subretinal fibrosis was evidenced in 24/25 (96%) eyes, most
prevalently in the outer retina (21/25, 84%) and in the choriocapillaris (18/25, 72%), where
main feature was white-hyperreflective (20/21, 95%) and dark-hyporeflective (17/18, 94%)
appearance, respectively. The presence of subretinal fibrosis on en face OCT was positively
correlated with the presence of abnormal vascular network on OCT angiography in
61% of the cases (P = 0.005).
Conclusion: Subretinal fibrosis secondary to myopic choroidal neovascularization
frequently contains blood flow within a persistent abnormal vascular network as assessed
by OCT angiography.