Analysis of the Natural Course of Quiescent Macular Neovascularization with Optical Coherence Tomography Angiography

Purpose This study investigates the natural progression of quiescent macular neovascularization (qMNV) using optical coherence tomography angiography (OCTA). Methods The study monitored 30 eyes of 28 qMNV patients over a period of at least six months. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and OCTA were used to perform qualitative and quantitative analyses, noting any cases of activation during follow-up. Results Among the 30 eyes (14 female, mean age 69.70 +/- 7.63 years), 21 had age-related macular degeneration (AMD) and 9 had pachychoroid neovasculopathy (PNV). The mean follow-up duration was 18.9 months. There were no significant changes in qualitative morphological features, BCVA, or choroidal thickness (p > 0.05). However, there was a statistically significant increase in the areas of MNV and flow (p = 0.043 and p = 0.018, respectively). BCVA and MNV area showed no significant correlation (p = 0.103). Four cases (13.33%) showed activation after an average follow-up period of 27.75 months (6 to 48). Additionally, extrafoveal location was identified as a significant risk factor for exudation (p = 0.033). Conclusion OCTA is a valuable tool for monitoring qMNV and identifying potential predictors of disease activation. The qMNV area may increase over time, even in the absence of activation. Extrafoveal location appears to be a potential risk factor for qMNV activation.