A retrospective analysis on comparison of optical coherence tomography manifestations among AMD, CEC, PM and ICN and its relationship with vision.

Abstract

Both macular choroidal neovascularization (MCN) and visual changes can occur in age-related macular degeneration (AMD), central exudative chorioretinopathy (CEC), pathological myopia (PM) and idiopathic choroidal neovascularization (ICN), but whether the optical coherence tomography (OCT) manifestations of the four diseases are different and their relationships with vision are not clear. This study clarifies this problem and can guide clinicians to prevent vision changes of patients according to OCT performance. 76 patients with MCN, included 25 AMD, 21 CEC, 18 PM and 12 ICN [refer to Chinese Ophthalmology (3rd Edition)], detected by OCT instrument, were enrolled in this study from June 2020 to June 2022. The OCT manifestations and indexes were observed. A comprehensive refractometer was used for detection of best corrected visual acuity (BCVA) and axial length (AL). Pearson chi squared and 1 way analysis of variance were used for enumeration data and continuous data test, and Pearson correlation coefficient was used for relationship analysis. (I) Macular edema proportions in the MCN eyes among AMD, CEC, PM and ICN groups were 96.00% and 94.12%, 14.29% and 14.29%, 44.44% and 32.00%, 33.33% and 28.57%, with statistical differences (both P<0.001). (II) Patients with macular edema had a significantly higher loose and thickened tissue reflex of the neuroepithelial layer (100.00% vs. 4.26%) and limited non-reflective dark area (100.00% vs. 4.26%) (both P<0.001). (III) PM had the lowest width, height and central fovea thickness (CFT) [(1,403.43±114.41), (210.74±21.22) and (250.70±41.36) μm], and the highest distance to the fovea, BCVA and AL [(234.44±288.69) μm, (0.30±0.08) Log minimal angle of resolution (MAR), (28.48±5.72) mm] (all P<0.001). (IV) The width and height of patients with macular edema were lower than those of patients without macular edema [(1,738.43±348.71) vs. (2,493.95±771.53) μm, P<0.001; (305.71±81.22) vs. (367.29±107.91) μm, P=0.002] (P<0.05). (V) The width and height, CFT were negatively correlated to BCVA (r=-0.635, -0.712, -0.724, all P<0.001), and height, CFT were negatively correlated to AL (r=-0.244, -0.275, P=0.018, 0.007). The distance to the fovea was positively correlated to BCVA and AL (r=0.241, P=0.019; r=0.267, P=0.007). Most of the OCT indexes were related to the BCVA and AL in MCN patients, and MCN patients with OCT changes should be reminded to protect their vision.