Fig. 5

Recurrence of mCNV with neovascular signal around PSV after anti-VEGF therapy. An 83-year-old woman had an active mCNV at initial visit and recurred four months later. The patient underwent one conbercept injection after the onset and another three conbercept injections after the recurrence. Upper row (a–h) shows the cSLO and OCTA images at initial visit. a cSLO shows that initial CNV (white circle) is visualized as a flat, tiny, greyish subretinal lesion. b En-face OCTA shows a high-flow network (initial CNV, orange icon 1 including a feeder vessel (white arrow). c–e A local magnification of b. The cross lines indicate the location of PSV, which is located away from the current CNV. The Bruch’s membrane is intact, however, the RPE layer has a local uplift. d is horizontal B-scans and e is vertical B-scans. The red arrowhead indicates the uplifted RPE, the yellow arrowhead indicates the PSV. f–h Another local magnification of b. The cross lines indicate the location of another PSV, corresponding to the feeder vessel of the CNV in f. PSV (yellow arrowhead) was identified as a hyporeflective linear region that was found below the CNV (red arrowhead, g, h) and around a neovascular signal (g). Lower row (i–p) shows the cSLO and OCTA images at the first recurrence visit. i A new CNV (red circle) has formed near the original CNV (white circle). j En-face OCTA shows the locations of the new CNV (blue icon 2) and the initial CNV (orange icon 1). k–m A local magnification of j. A new CNV (red arrowhead) has formed. PSV (yellow arrowhead) can be observed below the CNV (red arrowhead), and there is a new neovascular signal around it (l). n–p The initial CNV partially subsided and the initial neovascular signal cannot be observed (o). mCNV, myopic choroidal neovascularization; CNV, choroidal neovascularization; PSV, perforating scleral vessel; anti-VEGF, anti-vascular endothelial growth factor; cSLO, confocal scanning laser ophthalmoscopy; OCTA, optical coherence tomography angiography; RPE, retinal pigment epithelium