Background/aims To evaluate the diagnostic accuracy of spectral-domain optical coherence tomography (SD OCT) combined with OCT angiography (OCTA) for myopic myopic macular neovascularisation (MNV) activity. Methods Both eyes of patients with myopic MNV diagnosed with fluorescein angiography (FA), SD OCT and OCTA were assessed by unmasked investigators. The images were deidentified and randomised before graded by masked investigators, who determined the presence of active myopic MNV by using SD OCT together with OCTA without FA and by FA alone, respectively. The findings of masked investigators were compared with unmasked investigators. Results 213 eyes of 110 patients comprising 499 imaging episodes were eligible for grading. For diagnosing new-onset myopic MNV without FA, combined use of SD OCT and OCTA had a sensitivity of 0.94, specificity of 0.84 and area under the curve (AUC) of 0.92. FA had a sensitivity of 0.52 (p<0.01), specificity of 0.80 (p=0.38) and AUC of 0.66 (p<0.01). For recurrent myopic MNV, the combination of SD OCT and OCTA had a sensitivity of 0.98, specificity of 0.78 and AUC of 0.88. FA had a sensitivity of 0.50 (p=0.04), specificity of 0.76 (p=0.85) and AUC of 0.63 (p=0.01). Myopic traction maculopathy was more frequently associated with recurrent myopic MNV (p<0.01). Conclusion SD OCT with dense volumetric scan was highly sensitive for diagnosing myopic MNV. The addition of OCTA improved the diagnostic specificity without FA. Monitoring of the longitudinal changes on SD OCT and judicious use of FA is a reliable surveillance strategy for myopic MNV. Data are available on reasonable request. The data that support the findings of this study are available from the corresponding author, DS-CN, on reasonable request.

中文翻译：

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提高谱域光学相干断层扫描和光学相干断层扫描血管造影监测近视黄斑新生血管活动的准确性

背景/目的 评估谱域光学相干断层扫描 (SD OCT) 联合 OCT 血管造影 (OCTA) 对近视性黄斑新生血管 (MNV) 活动的诊断准确性。方法由不戴口罩的研究者对经荧光素血管造影（FA）、SD OCT 和 OCTA 确诊的近视 MNV 患者的双眼进行评估。这些图像在由蒙面研究人员进行分级之前被去识别化和随机化，他们分别通过使用 SD OCT 与不使用 FA 的 OCTA 以及仅使用 FA 来确定活动性近视 MNV 的存在。蒙面调查员的调查结果与未蒙面调查员的调查结果进行了比较。结果 110 名患者的 213 只眼睛（包含 499 个成像事件）符合分级条件。对于不带 FA 的新发近视 MNV 的诊断，联合使用 SD OCT 和 OCTA 的敏感性为 0.94，特异性为 0.84，曲线下面积 (AUC) 为 0.92。 FA 的敏感性为 0.52 (p<0.01)，特异性为 0.80 (p=0.38)，AUC 为 0.66 (p<0.01)。对于复发性近视 MNV，SD OCT 和 OCTA 联合的敏感性为 0.98，特异性为 0.78，AUC 为 0.88。 FA 的敏感性为 0.50 (p=0.04)，特异性为 0.76 (p=0.85)，AUC 为 0.63 (p=0.01)。近视牵拉性黄斑病更常与复发性近视 MNV 相关（p<0.01）。结论 SD OCT 密集容积扫描对于诊断近视 MNV 具有高度敏感性。添加 OCTA 提高了无需 FA 的诊断特异性。监测 SD OCT 的纵向变化并明智地使用 FA 是近视 MNV 的可靠监测策略。可根据合理要求提供数据。支持本研究结果的数据可根据合理要求从通讯作者 DS-CN 处获得。