Fig. 6

Changes of mCNV with neovascular signal around PSV after anti-VEGF therapy. A 57-year-old woman with an active myopic choroidal neovascularization at initial visit and recurred 38 months later. The patient underwent one ranibizumab injection after the onset, another one ranibizumab injection at three months and another two ranibizumab injections at the first recurrence. Each row represents images of the same follow-up time point. The first line represents en-face OCTA images, the second line represents en-face structure images, the third line represents horizontal cross-sectional OCTA B-scan, and the fourth line represents vertical cross-sectional OCTA B-scan. The baseline CNV (a1) shows a “Medusa” pattern, and a PSV (linear low reflection structure, a3, a4) can be seen under the CNV, corresponding to a black low-reflection lumen-like structure on en-face structure image (a2). Neovascular signal (red blood flow signal) can be observed around PSV (a3). One month after anti-VEGF therapy, the CNV decreased obviously (b1) and the neovascular signal around PSV cannot be observed (b3). Two months and three months after anti-VEGF therapy, the CNV area gradually increased (c1, d1) and the exudation under CNV increased significantly at three months (d3), which demonstrated that the mCNV was not stable after therapy. Therefore, she accepted another injection. The CNV was stable at 12 months (e1−e4). The mCNV recurred at 38 months. The CNV area increased from the baseline (f1), the exudation under CNV increased (f3, f4) and the neovascular signal can be observed around PSV again (f3). mCNV, myopic choroidal neovascularization; CNV, choroidal neovascularization; PSV, perforating scleral vessel; anti-VEGF, anti-vascular endothelial growth factor; OCTA, optical coherence tomography angiography