What was known before?

Myopic macular neovascularization (m-MNV), usually revealing itself as a macular hemorrhage, is a common complication in high myopia resulting in poor visual outcome, if left untreated.

Distinguishing macular hemorrhages due to myopic neovascularization from idiopathic macular hemorrhages in high myopic eyes can be challenging in clinical practice.

Fluorescein angiography (FA) is nowadays the gold standard to detect m-MNV; however, its invasiveness and the masking effect exerted by dense hemorrhages should be considered.

What this study adds

Optical coherence tomography angiography (OCTA) could be regarded as an excellent modality in identifying a neovascular pattern in cases of myopic hemorrhages, thus differentiating a neovascularization from an idiopathic macular hemorrhage with high sensitivity and specificity.

OCTA proved to be a reliable alternative to fluorescein angiography in the management of myopic macular hemorrhages.