Incidence and Enlargement Rate of Myopic Macular Neovascularization-Related Atrophy in Highly Myopic Eyes

Purpose: To investigate the incidence and enlargement rate (ER) of myopic macular neovascularization (MNV)-related atrophy in highly myopic (HM) eyes. Methods: This retrospective observational study included HM eyes treated for myopic MNV followed for ≥24 months. Atrophy was defined as a retinal pigment epithelium (RPE) disruption with hypertransmission on SD-OCT. The atrophic area detected on SD-OCT was delineated manually on en face infrared images and measured with a built-in feature. Only eyes with tessellated fundus or diffuse atrophy at baseline were included. Eyes with preexisting RPE atrophy, including patchy/MNV-related atrophy, were excluded. Results: Among 473 MNV eyes, 44 eyes of 40 patients (mean follow-up: 75.4 ± 37.7 months) met the inclusion criteria. Fifteen eyes (34.1%) developed MNV-related atrophy 23.37 ± 18.02 months after MNV onset. The atrophy area increased from 0.38 ± 0.67 mm 2 at diagnosis to 1.08 ± 1.45 mm 2 after 45.77 ± 26.45 months (p=0.011), corresponding to an ER of 0.22 ± 0.25 mm 2 /year. Larger MNV diameter and male gender were associated with MNV-related atrophy development. Conclusion: In HM eyes without preexisting RPE atrophy, one third showed MNV-related atrophy within 2 years of MNV onset. The atrophy ER was 0.22 ± 0.25 mm 2 /year, highlighting the importance of close monitoring