Fig. 2

Representative myopic pachychoroid neovascularization (Case 9). A 60’s patient was referred to our clinic for evaluation of age-related macular degeneration. Patient did not have any previous medical history. At presentation, refractive error was − 6.0 diopters, and best-corrected visual acuity was decreased to 20/40 in the left eye. a Optical coherence tomography showed foveal detachment with double layer sign above pachyvessel (arrowhead). There was no evidence of any vitreomacular traction or hole. b In the early phase, fluorescein angiography showed ill-defined leakage, and indocyanine green angiography showed abnormal choroidal vessel and dilated choroidal vessel. c In the late phase, fluorescein angiography showed mild diffuse leakage similar to early phase and indocyanine green angiography showed choroidal hyperpermeability and punctate hyperfluorescence dot (arrowhead), choroidal leakage on choroidal neovascularization. d Outer-retinal slab on optical coherence tomographic agiography showed clear vascularity of choroidal neovascularization. e B scan flow overlay showed vascular flow (red color) within a double layer sign. f On 64 months after two photodynamic therapy and multiple anti-VEGF injection treatments under the diagnosis of type 1 choroidal neovascularization in myopia, optical coherence tomography showed persistent subretinal fluid. Best corrected visual acuity was slightly decreased to 20/63