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

Purpose: To evaluate whether increased ultra-widefield (UWF) red-separation reflectance and choroidal thinning are associated with myopic choroidal neovascularization (mCNV) in eyes with posterior staphyloma using a paired-eye design. Methods: This retrospective paired-eye study included 35 patients who had both bilateral pathologic myopia and posterior staphyloma, with unilateral mCNV. Red-separation UWF images were used to measure the mean intensity of the posterior staphyloma (PS) and outer (O) areas, and the reflectance ratio (RR) was recalculated as PS/O. Choroidal thickness (CT), posterior staphyloma height, and coefficient α were measured on spectral-domain optical coherence tomography. Matched associations with mCNV were analyzed using conditional logistic regression stratified by patient. Results: Eyes with mCNV had lower CT (44.91 ± 22.03 vs. 62.37 ± 28.66 μm; P