Abstract
Background. Optical coherence tomography angiography (OCTA) is a relevant modern method for visualizing choroidal neovascularization and may be promising in assessing retinal microcirculation in various fundus diseases. Aim. To conduct a comparative analysis of retinal microcirculation using OCTA in assessing the course of choroidal neovascularization (CNV) in pathological myopia (PM) and in wet age-related macular degeneration in combination with axial myopia (AMD + M) against the background of antiangiogenic therapy. Methods. The prospective study included 70 people (107 eyes, 70 of them with new-onset CNV). The patients were divided into 2 groups: the first group with pathological myopia (PM) – 47 people (47 eyes), the second group – with wet age-related macular degeneration in combination with medium and high axial myopia (AMD + M) with axial eyes length over 25.00 mm – 23 people (23 eyes). Results. In the PM group, in eyes with CNV, the values of the axial length of the eyes are significantly greater than in AMD + M (29.00 (27.98–29.66) and 25.42 (24.25–27.55) mm, respectively). Initial values of retinal microcirculation in the fovea did not differ between the groups. By the end of the observation period, the area and perimeter of the foveal avascular zone (FAZ) in PM increased significantly due to the progression of degenerative changes in the retina (FAZ area from 0.231 (0.214; 0.260) to 0.302 (0.247; 0.396) mm²; FAZ perimeter from 1.970 (1.897; 2.095) to 2.315 (1.997; 2.645) mm). In AMD + M these indicators significantly decreased due to a decrease in exudative changes in the retina (FAZ area from 0.268 (0.216; 0.398) to 0.191 (0.1345; 0.231) mm² , FAZ perimeter from 2.169 (1.879; 2.574) to 1.478 (1.437; 1.773) mm). Degenerative changes in the fovea and the periphery of the retina with a history of laser coagulation showed a strong direct correlation. Conclusion. OCTA reflects the distinctive features of retinal microcirculation in eyes with CNV in patients with PM and AMD + M at baseline and over time during antiangiogenic therapy. Key words: optical coherence tomography-angiography; OCTA; pathological myopia; age-related macular degeneration; choroidal neovascularization; anti-VEGF therapy; anti-angiogenic therapy.
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