Significance of chorioretinal atrophy using ultra-widefield reflectance image as a risk factor for myopic choroidal neovascularization

Abstract

Abstract We evaluated chorioretinal atrophy as a risk factor for myopic choroidal neovascularization (mCNV) in patients with posterior staphyloma using ultra-widefield (UWF) imaging. This retrospective study enrolled 35 patients with bilateral pathologic myopia and posterior staphyloma and unilateral mCNV. The fellow eyes showed no signs of mCNV. To assess the risk factors for mCNV, we measured the reflectance using red separation UWF images and analyzed the reflectance ratio (RR) of the posterior staphyloma area to that of the other areas. Additionally, choroidal thickness (CT), posterior staphyloma height, and coefficient α which represent the foveal curvature were measured on spectral domain optical coherence tomography images. Axial length, refractive error, and myopic macular degenerative changes were comparable between the affected and unaffected eyes. In the multivariate analysis, thin CT and increased RR were significant risk factors for mCNV (P = 0.031 and P = 0.009, respectively). There was a significant negative correlation between the CT and RR (P = 0.026). RR had the highest predictive value for mCNV on the receiver operating characteristic curve (P = 0.002). Increased reflectance of the posterior staphyloma area, which reflects chorioretinal atrophy, may be a significant parameter for assessing the risk of mCNV in pathologic myopia.