Optical coherence tomography angiography imaging characteristics and clinical significance of the foveal vertical hyperreflective line in patients with macular neovascularisation.

BACKGROUND

To investigate the incidence, characteristic manifestations, outcomes of changes, and potential clinical significance of the foveal vertical hyperreflective line (FVHL) on optical coherence tomography angiography (OCTA) in patients with macular neovascularisation (MNV).

METHODS

This retrospective observational case series was conducted using OCTA images, fundus photographs, best-corrected visual acuity measurements, and other clinical information of the eyes of patients with MNV who were followed up for at least 3 months between January 2024 and October 2025. The incidence of FVHLs, OCTA characteristics, FVHL changes, and prognoses were analysed.

RESULTS

Among the 322 eyes of 161 patients with MNV, 14 patients (8.7%) showed FVHLs in 15 eyes. The mean age of the patients was 69.29 ± 12.68 years. Among the eyes with an FVHL, 13 were of patients with age-related macular degeneration-MNV and two were of patients with pathological myopia-MNV. All cases showing FVHLs occurred in the early stages of the disease course (within 1-3 months) and did not disappear during follow-up. Among the cases with FVHLs, 80% showed no obvious changes in the FVHLs and 20% showed weakened reflexes. The eyes that showed FVHL maintenance had a higher interdigitation zone/ellipsoid zone (IZ/EZ) repair rate (91.7%) than those with reflex-weakened FVHLs (p = 0.009).

CONCLUSIONS

FVHLs were present in 8.7% of patients with MNV. The eyes that maintained FVHLs exhibited a higher degree of IZ/EZ restoration than the eyes with reflex-weakened FVHLs. This OCTA finding may provide a foundation for assessing the recovery responses of retinal photoreceptors and Müller cells.