Purpose: To assess changes in myopic maculopathy based on the ATN classification system with optical coherence tomography angiography.
Methods: This was a cross-sectional study. The macular choroidal thickness (MCT) and the choriocapillaris flow (CC) were measured with optical coherence tomography angiography. The relationship of MCT and CC with different chorioretinal atrophy (A), myopic foveoschisis (T), and myopic neovascularization (N) grades was investigated.
Results: One hundred and fifty-three participates (219 eyes) were included. MCT and CC had no significant correlation with different T grades (P > 0.05). Choriocapillaris flow had a significant decrease in eyes with lacquer cracks compared with those with no neovascular maculopathy (P < 0.05) and showed a significant increase in active choroidal neovascularization compared with those with lacquer cracks (P < 0.05). Macular choroidal thickness and CC had negative correlations with different A grades (P < 0.001). MCT showed the greatest decrease in the early stage of myopic atrophic maculopathy (P < 0.001), and CC showed the most significant reduction in the late stage (P < 0.001).
Conclusion: Choroidal changes in the highly myopic patients were detected by optical coherence tomography angiography. Progressive ischemia in the macula may play an important role in the development of myopic atrophic maculopathy. Active choroidal neovascularization may have manifested as compensation for the decrease in MCT and CC. On the contrary, myopic traction maculopathy had little correlation with choroidal changes.