Assessment and role of artery-vein complex in myopic choroidal neovascularization using Optical Coherence Tomography Angiography.

To analyze the presence of an artery-vein complex (AVC) underneath myopic choroidal neovascularization (mCNV) and to determine its relationship with neovascular activity.Retrospective analysis of 681 eyes from 362 patients with high myopia defined by an axial length (AL) of >26mm using optical coherence tomography (OCT) and OCT angiography (OCTa) imaging. Patients with clinical diagnosis of mCNV and good quality OCTa images were then selected. An AVC was defined by the identification of both perforating scleral vessels (PSV) and dilated choroidal veins (DCV) under or in contact with the mCNV in the same case. Swept-source OCT (SS-OCT) and SS-OCT angiography images (TRITON; Topcon Corporation, Japan) were reviewed to detect AVC in the mCNV area.Results: 50 eyes of 49 highly myopic patients with mCNV were analyzed. Eyes with AVC were statistically older (69.95±13.53 vs. 60.83±10.47 years-old; p<0.01), needed less intravitreal injections/year along the follow-up period (0.80±0.62 vs. 1.92±0.17; p<0.01) and showed less relapses/year (0.58±0.75 vs. 0.46±0.42; p<0.05) when compared to eyes without AVC. Moreover, eyes with AVC were less likely to relapse during the first year from mCNV activation (n=5/14 vs. n=14/16; p<0.01; p<0.01). No significant differences were found regarding either AL (30.55±2.31 vs. 29.65±2.24, p>0.05) or BCVA (0.4±0.5 vs. 0.4±0.5 logMAR, p>0.05) between groups.AVC complex has an influence over myopic choroidal neovascularization activity resulting in less aggressive neovascular lesions than those with PSVs only.