Bilateral vitrectomy in patients with proliferative diabetic retinopathy-characteristics and surgical outcomes.

PURPOSE: Comparing characteristics and outcomes of patients with bilateral proliferative diabetic retinopathy (PDR) undergoing concurrent and sequential vitrectomy. METHODS: Patients having bilateral vitrectomy were classified into concurrent (requiring bilateral surgery simultaneously) and sequential (indicating vitrectomy in one eye later) groups. Clinical characteristics and outcomes were compared, and correlation between the first and second-operated eyes was analyzed. RESULTS: One hundred eight and 126 eyes were in the concurrent and sequential groups, respectively. The sequential group was older (50 vs. 45 years, P = 0.017), had less retinal detachment (54 vs. 77%, P < 0.001), and better visual outcomes (0.79 vs. 1.30, P = 0.021), especially the second-operated eyes. The concurrent group had weaker correlations of disease severity (phi coefficient: 0.36 vs. 0.61) and post-operative visual acuity (r: 0.12 vs. 0.34) between the first- and second-operated eyes than the sequential group. Prior intravitreal injection of anti-vascular endothelial growth factor (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.15-0.86, P = 0.025) predicted better outcomes, while post-operative neovascular glaucoma predicted worse outcomes (OR 6.5, 95% CI 1.7-27.9, P = 0.008). CONCLUSIONS: PDR patients requiring surgery concurrently were younger and had more severe diseases and worse outcomes. However, poor outcomes in the first eye did not predict similar outcomes in the second eye.

Lamellar macular hole in highly myopic eyes and insights into its development, evolution, and treatment: a mini-review.

Lamellar macular holes (LMHs) are a manifestation of myopic tractional maculopathy (MTM). Owing to the complex and multidirectional traction force in the elongated eyeball, the clinical features, development, evolution, and treatment algorithms of LMH in highly myopic eyes may differ from those of idiopathic LMH or MTM in general. This review aimed to specifically explore the LMHs in highly myopic eyes. Several developmental processes of LMH and their association with macular retinoschisis have been demonstrated, with the tractional component identified in all processes. Epiretinal proliferation was more prevalent and more extensive in LMHs in highly myopic eyes than in idiopathic LMHs. LMHs in highly myopic eyes may remain stable or progress to foveal detachment and full-thickness macular hole with or without retinal detachment. The predictive factors associated with disease progression were summarized to facilitate monitoring and guide surgical intervention. The treatment of LMHs in highly myopic eyes was based on an algorithm for treating myopic tractional maculopathy, including gas tamponade, pars plana vitrectomy, macular buckling, and a combination of vitrectomy and macular buckling. New internal limiting membrane (ILM) manipulation techniques such as fovea-sparing ILM peeling or fovea-sparing ILM peeling combined with ILM flap insertion could reduce the risk of developing iatrogenic full-thickness macular holes postoperatively. Further research should focus on the treatment of LMH in highly myopic eyes.

Surgical outcomes and intraoperative parameters of 3D visualization system versus conventional microscopes for macular surgery in highly myopic eyes, a prospective randomized clinical trial.

PURPOSE: To investigate the surgical outcomes and intraoperative parameters of 3D visualization system for macular diseases in highly myopic eyes. METHODS: In this single-center, prospective, randomized, comparative interventional study, 40 highly myopic eyes (axial length > 26mm) were randomly assigned to either a 3D visualization system or a conventional microscope (CM) group. Surgical outcomes and intraoperative parameters, including the number of indocyanine green (ICG) injections, surgical time, and epiretinal membrane (ERM)/ internal limiting membrane (ILM) peeling time, were compared. RESULTS: The 3D group required significantly fewer ICG injections (1.3 ± 0.5 vs. 2.3 ± 0.7, p < 0.001), had shorter ERM/ILM peeling times (522.8 ± 258.0 vs. 751.8 ± 320.2 sec, p < 0.05), and experienced fewer intraoperative retinal hemorrhages (0 vs. 7 cases, p < 0.05) compared to the CM group. Anatomical and functional outcomes were comparable between the two groups. CONCLUSION: The 3D system exhibited a lower number of ICG injections, shorter ERM/ILM peeling times and a reduced incidence of intraoperative retinal hemorrhages, suggesting the 3D visualization system may offer advantages for macular surgery in highly myopic eyes.

Associations between macular retinal vasculature and severity of idiopathic epiretinal membrane.

BACKGROUND: To demonstrate the associations between the morphology of macular retinal vasculature and disease severity of idiopathic epiretinal membrane (ERM). METHODS: Macular structures were assessed using optical coherence tomography (OCT), and were classified as "with pseudohole" or "without pseudohole". The 3 × 3 mm macular OCT angiography images were analyzed using the Fiji software to obtain the vessel density, skeleton density, average vessel diameter, vessel tortuosity, fractal dimension, and foveal avascular zone (FAZ)-related parameters. The correlations between these parameters and ERM grading as well as visual acuity were analyzed. RESULTS: For ERM with or without a pseudohole, increased average vessel diameter, decreased skeleton density, and decreased vessel tortuosity were all associated with inner retinal folding and thickened inner nuclear layer, indicating more severe ERM. In 191 eyes without a pseudohole, the average vessel diameter increased, fractal dimension decreased and vessel tortuosity decreased with increasing ERM severity. The FAZ was not associated with ERM severity. Decreased skeleton density (r = -0.37), vessel tortuosity (r = -0.35), and increased average vessel diameter (r = 0.42) were correlated with worse visual acuity (All P < 0.001). In 58 eyes with pseudoholes, a larger FAZ was associated with a smaller average vessel diameter (r = -0.43, P = 0.015), higher skeleton density (r = 0.49, P < 0.001), and vessel tortuosity (r = 0.32, P = 0.015). However, none of the retinal vasculature parameters correlated with visual acuity and central foveal thickness. CONCLUSION: Increased average vessel diameter, decreased skeleton density, decreased fractal dimension and decreased vessel tortuosity were good indicators of ERM severity and associated visual impairment.

Evaluation of the association between macular damage and disability glare in patients with advanced glaucoma.

PURPOSE: This study aimed to investigate the factors associated with disability glare in patients with advanced glaucoma and evaluate the impact of disability glare on the vision-related quality of life. METHODS: We prospectively studied 225 eyes (225 patients) with advanced glaucoma. The visual function was evaluated using the 10-2 and 24-2 Humphrey visual field (VF) (Dublin, California) and contrast sensitivity test. Structural parameters were obtained using RTVue optical coherence tomography and angiography (Fremont, California). Significant loss of macular vessel density (mVD) was defined as VD < 30%. Each participant completed the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) and questions regarding subjective symptoms of glare. RESULTS: Fifty-six patients (24.9%) experienced glare and had a lower NEI-VFQ-25 composite score (P = 0.017). The average retinal nerve fiber layer and ganglion cell complex thickness and mean deviation (MD) in the 24-2 VF test were not associated with glare. Significant superior or inferior mVD loss (P < 0.001; odds ratio [OR], 3.45; and 95% confidence interval [CI], 1.83-6.55), lower logarithmic contrast sensitivity at 0.75 cycles/degree (P < 0.001; OR, 0.27; and 95% CI, 0.13-0.56), and worse MD in the 10-2 VF test (P < 0.001; OR, 0.93; and 95% CI, 0.89-0.97) showed an association with glare. CONCLUSION: In advanced glaucoma, central VF defect and mVD loss are associated with disability glare, which negatively impacts vision-related quality of life.

Formation and evolution of idiopathic lamellar macular hole-a pilot study.

BACKGROUND: The developmental pathways and subsequent evolutional processes of idiopathic lamellar macular hole (LMH) were studied with spectrum domain optical coherence tomography (SD-OCT). METHODS: Twenty-seven eyes of 26 patients of idiopathic LMH with pre-LMH SD-OCT available were retrospectively reviewed. Relevant OCT parameters and best-corrected visual acuity (BCVA) were collected and analyzed. RESULTS: Four types of developmental pathways of idiopathic LMH were noted. Type 1 (5 cases), involved disruption of a foveal cyst from vitreomacular traction. Type 2 (10 cases), demonstrated rupture of parafoveal cysts or schisis mainly from epiretinal membrane (ERM). In type 3 pathway (5 cases), a central intraretinal cyst formed under tight ERM with subsequent cyst roof dehiscence. Type 4 (7 cases), showed gradual loss of foveal tissue without cystic lesions from ERM traction. There was no statistically significant change in BCVA during LMH formations or subsequent evolutional processes in any types of the developmental pathways. Three cases developed epiretinal proliferation (EP) during evolution, which showed tendency of decrease in BCVA. Among the three cases, one later developed the degenerative configuration. CONCLUSIONS: In summary, four types of tractional developmental pathways of idiopathic LMH were identified. BCVA was relatively stable during LMH formation and follow-up. Deterioration of visual acuity were found in cases that developed EP during evolution. Transformation into degenerative configuration might be possible after LMH formation.

Long-term structural and functional outcomes of primary congenital glaucoma.

PURPOSE: To investigate the clinical characteristics and long-term outcomes of primary congenital glaucoma (PCG) patients. METHODS: In this retrospective, longitudinal, cohort study, PCG patients with reliable visual field (VF) tests and optical coherence tomography (OCT) were included. Disease progression was detected using guided progression analysis with OCT and the change analysis of mean deviation (MD) slope with VF tests. Factors associated with the disease progression and visual prognosis were analyzed. RESULTS: Twenty-nine eyes from 11 bilateral and 7 unilateral PCG patients were enrolled. LogMAR visual acuity declined (0.15 vs. 0.40, P < 0.001). The change rate of the average retinal nerve fiber layer thickness was - 0.83 ± 1.45 µm/year, and 28% of eyes showed glaucoma progression on OCT. The median of the MD slope was 0.16 (- 1.19 to 1.07) dB/year, and 14% of eyes showed glaucoma progression on the VF test. Higher average intraocular pressure (IOP) (P = 0.046) and IOP fluctuation (P = 0.031) predicted disease progression. None of the fellow eyes of unilateral PCG patients developed glaucoma during the follow-up. At last, 59% of eyes had visual acuity > 20/70, and 31% had MD > - 6 dB. Patients with worse baseline visual acuity (P = 0.027), worse baseline MD (P < 0.001), and smaller neuroretinal rim area (P < 0.001) showed worse final MD values. CONCLUSIONS: Aggressive IOP control is necessary to prevent structural and functional decline in PCG patients. Their fellow eyes are not at risk of glaucoma. Baseline neuroretinal rim area can predict the functional outcome.

Hyperreflective foci in predicting the treatment outcome of antivascular endothelial growth factor in neovascular age-related macular degeneration.

PURPOSE: To describe the optical coherence tomographic findings of hyperreflective foci (HF) in neovascular age-related macular degeneration and evaluate the use of HF to predict visual outcome after antivascular endothelium growth factor (anti-VEGF) therapy. METHODS: This was a post-hoc analysis of a retrospective cohort study. Hyperreflective foci were localized in the inner retina, outer retina, or subretinal fluid (SRF) layer. The treatment response of HF was recorded. The association between HF and visual outcome was analyzed. RESULTS: We enrolled 126 eyes. Hyperreflective foci involving more than one layer were associated with poor initial visual acuity (P < 0.001). Hyperreflective foci in each layer at baseline were negatively correlated with baseline visual acuity. At 3 months posttreatment, HF in the SRF layer had decreased significantly (P = 0.003), which was faster compared with HF in other layers. Baseline HF status at each layer was not associated with final visual outcome. The eyes with reduced HF in the SRF at 3 months had better visual improvement at 12 months (P = 0.038). CONCLUSION: Hyperreflective foci involving multiple layers were associated with poor initial visual acuity but not with final visual outcome. With anti-VEGF treatment, HF in the SRF layer resolved faster, which may predict better visual outcome.

Clinical characteristics of glaucoma patients with disc hemorrhage in different locations.

PURPOSE: To compare the clinical characteristics and outcomes of eyes with unilateral disc hemorrhage (DH) in different locations. METHODS: This was a retrospective cohort study. DHs were classified by locations: the superior, superotemporal, inferotemporal, or inferior sectors of optic disc were classified as the susceptible area, while other sectors were defined as the less susceptible area. Structural and functional outcomes were analyzed by the Humphrey field analyzer and spectral domain optical coherence tomography. RESULTS: Forty-three eyes with DHs in the susceptible area were less myopic and had more peripapillary-type DH, larger cup-to-disc ratio, cup volume, and disc area. Thirty-three eyes with DHs in the less susceptible area had less association with RNFL defects, greater tilted ratio, and less torsion of the disc. Follow-up revealed that the change in sectoral RNFL (µm) thickness was significantly greater for DHs in the susceptible area within one year (- 6.0 ± 14.0 vs. 0.7 ± 13.0, p = 0.035) and two years (- 10.0 ± 17.4 vs. - 1.1 ± 7.6, p = 0.012), while the change in average RNFL thickness was not different. Eyes with DHs in the susceptible area had faster MD deterioration (dB/year) than those in the less susceptible area within four years (- 0.32 ± 0.51 vs. - 0.05 ± 0.45, p = 0.047). A total of 16.9% of eyes, all in the susceptible area, had localized VF progression at DH corresponding area. CONCLUSION: Disc hemorrhage in the superotemporal and inferotemporal regions had more subsequent structural and functional deterioration compared with the eyes with DHs in the temporal quadrant and nasal area.

Epibulbar complex choristoma with simultaneous involvement of eyelid: a case report.

BACKGROUND: Epibulbar complex choristoma, a rare congenital epibulbar tumor, has many diverse forms. Reviewing the literature, it can present clinically as either a circumferential or isolated epibulbar mass, limbal tumor, lateral canthal mass, aggregate of ectopic cilia in the upper eyelid, eyelid mass mimicking chalazion, or lacrimal caruncle mass. The management depends on the extent of involvement, the risk of amblyopia, and cosmetic concerns. Here, we report an atypical presentation of epibulbar complex choristoma with simultaneous eyelid involvement. CASE PRESENTATION: A 1-month-old full-term boy was brought to our clinic with congenital epibulbar mass of the right eye with simultaneous eyelid involvement. Dilated fundus examination was unremarkable. Survey for linear nevus sebaceous Jadassohn was negative. Due to concerns of possible amblyopia and cosmetics, lamellar keratectomy, sclerotomy, and conjunctivoplasty were performed to remove the epibulbar lesion. The eyelid defect was reconstructed with 6-0 Vicryl sutures. Histopathological examination reported complex choristoma. Upon three-year follow-up, low astigmatism and favorable cosmetics results were achieved. CONCLUSIONS: Congenital complex choristoma can present clinically as an epibulbar mass with eyelid involvement. The management depends on the extent of involvement, the risk of amblyopia, and cosmetic concerns. The method of eyelid reconstruction should be tailored according to the residual eyelid defect.

Long-term follow-up of retinal nerve fiber layer cleavages in glaucoma patients and suspects.

PURPOSE: To investigate the structural and functional characteristics and change of the retinal nerve fiber layer cleavages (RNFLCs) in glaucoma patients and suspects in long-term follow-up. METHODS: This is a retrospective longitudinal study. Within 43 eyes of 30 subjects, 62 RNFLC locations were detected on color fundus photography. Basic ophthalmic examinations, color fundus photography, optical coherence tomography (OCT), and visual field (VF) test were performed in 6-month intervals. Clinical characteristics and the structural and functional changes of the cleaved areas were analyzed. RESULTS: RNFLC and localized vitreoretinal traction occurred most commonly along the superotemporal retinal vessel arcade. Nine locations had corresponding defects on OCT deviation map, while 31 locations were associated with defects on OCT deviation map. Three locations had corresponding VF defects. More of the non-highly myopic eyes had lamellar hole than the highly myopes (p = 0.038). The RNFLC lesions in glaucomatous eyes were more frequently associated with OCT defects on deviation map (p = 0.021). There was no difference in the presence of lamellar hole or the number of RNFLCs between the glaucomatous and non-glaucomatous eyes. During a 66.8 ± 37.8-month follow-up, there was no structural or functional progression of the RNFLCs as determined by color fundus photography, VF test, and GPA of OCT interpreted by three ophthalmologists. There was no statistically significant change of RNFLC area (p = 0.268). CONCLUSIONS: RNFLC did not show detectable functional or structural change in early glaucoma patients and suspects after long-term follow-up.

Impact of atropine use for myopia control on intraocular pressure in children: A comprehensive review including postpupil dilation intraocular pressure changes.

Topical atropine has been widely used for controlling myopia progression in children, yet its long-term efficacy and safety, including potential intraocular pressure (IOP) elevation, are still being studied. The mydriasis and cyclopegia induced by atropine may reduce traction on the trabecular meshwork, together with pigment released into anterior chamber due to the friction between the iris and lens during pupil dilation, may obstruct and reduce the trabecular outflow. This review first explores postdilation IOP changes across different groups - healthy individuals, glaucoma patients, and children. The response to pupil dilation varies widely, with IOP potentially increasing or decreasing. Glaucoma patients, whether with open or closed-angle glaucoma, may experience more significant IOP rises postdilation. The second section examines IOP effects in children using topical atropine for myopia, where most of the 25 reviewed studies showed nonsignificant IOP changes, although slight increases were observed in a few. In addition, no alterations in the retinal nerve fiber layer thickness were found. However, the research on children's IOP under topical atropine is constrained by small sample sizes, cross-sectional studies, brief follow-ups, and often lacks control groups or pretreatment IOP measurements. Given the extended atropine use for myopia and the significant individual variation in IOP response, we recommend routine IOP monitoring for children receiving topical atropine.

The Changes in Ocular Biomechanical Response Parameters and Intraocular Pressure After Surgical Treatment for Thyroid Eye Disease.

Purpose: To investigate changes in ocular biomechanical response parameters and intraocular pressure (IOP) in patients with thyroid eye disease (TED) undergoing orbital decompression or anterior blepharotomy. Methods: Eighty-three eyes from 46 patients receiving orbital decompression (the orbital decompression group) and 45 eyes from 28 patients receiving anterior blepharotomy (the anterior blepharotomy group) were retrospectively enrolled from a tertiary center. Corvis ST tonometry was used to assess ocular biomechanical response and biomechanically corrected IOP (bIOP) pre- and postoperatively. Non-contact tonometry (IOP-NCT) was also performed. Results: In the anterior blepharotomy group, the margin reflex distance decreased (P < 0001). The highest concavity radius (P = 0.026) and whole eye movement (P = 0.003) increased. Neither IOP-NCT nor bIOP had a significant change. In the orbital decompression group, the extent of exophthalmos decreased (P < 0.001). The A2 length (P = 0.009) decreased. The bIOP did not show a significant change (16.4 ± 2.7 vs. 16.7 ± 4.5; P = 0.415), but the IOP-NCT decreased significantly (17.5 ± 3.3 vs. 16.0 ± 3.3; P < 0.001). Higher baseline IOP-NCT (ß = -0.40, P < 0.001) and greater reduction in stiffness parameter A1 (SP-A1; ß = 0.05, P = 0.002) were associated with more significant IOP-NCT reduction after the orbital decompression. Conclusions: Ocular biomechanical response parameters may change after TED surgery, potentially affecting IOP measurements, particularly in patients receiving orbital decompression.

Relationship between the Macular Microvasculature and Central Visual Field Sensitivity in Patients with Advanced Glaucoma.

PURPOSE: To evaluate the relationship between central visual field sensitivity (cVFS) and the structural parameters in patients with advanced glaucoma. DESIGN: Cross-sectional study. METHODS: In total, 226 eyes of 226 patients with advanced glaucoma were classified into the "minor central defect" (mean deviation on 10-2 visual field test [MD10] > -10 dB) and "significant central defect" (MD10 ≤ -10 dB) groups. We examined the structural parameters using RTVue OCT and angiography, including the retinal nerve fiber layer, ganglion cell complex, peripapillary vessel density (VD), and superficial and deep macular VD (mVD). The assessment of cVFS included MD10 and the mean deviation of the central 16 points on the 10-2 VF test (MD16). We used Pearson correlation and segmented regression to assess the global and regional relationships between the structural parameters and cVFS. MAIN OUTCOME MEASURES: Correlation between structural parameters and cVFS. RESULTS: In the minor central defect group, the best global correlations existed between the superficial macular and parafoveal mVD and MD16 (r = 0.52 and 0.54, P < 0.001). In the significant central defect group, superficial mVD best correlated with MD10 (r = 0.47, P < 0.001). Segmented regression between superficial mVD and cVFS revealed no breakpoint was found as MD10 declined, but a breakpoint was identified at -5.95 dB for MD16, which was statistically significant (P < 0.001). The regional correlations between the grid VD and sectors of the central 16 points were significant (r = 0.20-0.53, P= 0.010 ∼P < 0.001). CONCLUSIONS: The fair global and regional relationships between mVD and cVFS suggest that mVD may be beneficial for monitoring cVFS in patients with advanced glaucoma. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

The development and evolution of lamellar macular hole in highly myopic eyes.

BACKGROUND/OBJECTIVES: To study the development, evolution, outcomes, and prognostic factors of lamellar macular hole (LMH) in highly myopic (HM) patients. METHODS: Fifty eyes from 47 HM patients with LMHs were retrospectively enrolled. Relevant pre- and post-LMH optical coherence tomography findings and visual acuity were collected. Structural progression was defined as an increase in the height of retinoschisis, and the development of foveal detachment, full-thickness macular hole, or retinal detachment. RESULTS: Four traction-related developmental processes were identified. Type 1 LMHs (8, 16%) developed from foveal avulsion caused by vitreomacular traction. Type 2 (32, 64%) and type 3 LMHs (5, 10%) formed from ruptured parafoveal and central foveal cysts, respectively. Progressive foveal thinning caused by epiretinal membranes (ERMs) without cystic changes led to type 4 LMHs (5, 10%). Retinoschisis developed before (9 eyes), after (10 eyes), or simultaneously with (6 eyes) the LMH formation. Structural progression was noted in 50%, 53%, 0%, 100% of patients with type 1-4 LMHs, respectively. Multivariable Cox proportional hazard model showed that greater residual foveal thickness (P = 0.001, adjusted odds ratio = 0.22, 95% confidence interval [CI], 0.08 ~ 0.56), and the absence of retinoschisis were protective against structural progression. Multivariable linear regression showed that poor baseline visual acuity (P < 0.001, ß = 0.74, 95% CI 0.41 ~ 1.07) and type 4 LMH predicted worse visual outcomes. CONCLUSIONS: Four traction-related LMH developmental processes were observed in HM eyes and exhibited different evolution and outcomes. LMHs with foveal thinning induced by ERMs had the worst outcomes.

Characteristics and treatment response of polypoidal choroidal vasculopathy in highly myopic eyes.

BACKGROUND: To compare the characteristics and treatment responses of polypoidal choroidal vasculopathy (PCV) between highly myopic and non-highly myopic eyes. METHODS: This retrospective cohort study included patients diagnosed with PCV at the clinic of National Taiwan University Hospital between 2013 and 2019. The diseased eyes were grouped per refractive error and axial length at diagnosis. Imaging data were used to retrieve the PCV characteristics, and electronic medical records were used to retrieve the treatment responses. RESULTS: Among 116 eyes with PCV, 11 eyes of 10 patients were highly myopic; seven of these patients were women. All highly myopic eyes showed a thin subfoveal choroid, while three eyes had a pachychoroid phenotype with significant focal choroidal thickening. After treatment with either intravitreal anti-vascular endothelial growth factor (VEGF) injections, photodynamic therapy (PDT), or both, best-corrected visual acuity was better in the high-myopia group at 1 year. Visual acuity at presentation and the presence of feeder vessels were found to be predictors of the visual outcome. CONCLUSIONS: In this study we reported, to the best of our knowledge, the largest cohort of PCV in highly myopic eyes to date. Female predominance, lower incidence of subretinal haemorrhage, and a thin choroid with a focal pachychoroid phenotype were found to characterise PCV in highly myopic eyes. Visual acuity transiently improved after either anti-VEGF monotherapy or combination therapy with PDT.

Characteristics and response of subretinal hyperreflective material to anti-vascular endothelial growth factor in myopic choroidal neovascularization.

This retrospective study evaluated the characteristics and response of subretinal hyperreflective material (SHRM) to anti-vascular endothelial growth factor (VEGF) treatment in eyes with myopic choroidal neovascularization (CNV). The visual acuity (VA) was assessed at 3, 6, and 12 months after initiating anti-VEGF treatment in 116 patients (119 eyes) with SHRM and myopic CNV. Multimodal imaging, including color fundus photography, fluorescein angiography (FA), and optical coherence tomography angiography (OCT-A), were performed. We compared type 2 neovascularization (NV) (n = 64), subretinal hyperreflective exudation (SHE) (n = 37), NV with hemorrhage (n = 15), and fibrosis (n = 3). The type 2 NV group, and NV with hemorrhage groups showed significant VA improvement after 12 months of treatment (p < 0.05 in both groups); the SHE group failed to show improvement (p = 0.366). All groups showed a significant reduction in central foveal thickness after 12 months of treatment (all p < 0.05). The SHE group had a significantly higher incidence of interrupted ellipsoid zone than the other groups (p < 0.05). Myopic CNV can present as SHRM on OCT-A. Visual prognoses vary in different SHRM types. OCT-A and FA may help predict the outcomes of different subtypes of myopic CNV. SHE is predictive of outer retinal layer atrophy in patients with various SHRM types.