Abstract
Purpose :
To determine the correlation between the duration of myopic choroidal neovascularization (CNV) and visual outcome and to identify the baseline predictors for final visual outcome.
Methods :
Treatment naïve patients who were received one or more intravitreal anti-VEGF injection and who were followed for at least 24 months due to myopic CNV, were divided into three groups based on the duration of their CNV (group A: <2 , B: 2-8, group C: 8-24 weeks). We evaluated the correlation between the duration of the CNV and the treatment outcomes including the BCVA improvement and the decrease in central retinal thickness (CRT) at six, 12, 24 months and at the time of their final visit. The predictive factors related to their final visual outcome as well as the recurrence of CNV were identified.
Results :
In a total 106 eyes of 100 patients; there were 26 eyes in group A, 36 eyes in group B and 44 eyes in group C. The mean baseline BCVA (0.48, 0.50 and 0.74), CRT (339.4, 317.8 and 365.5μm) and the presence of subfoveal hemorrhage (73%, 39% and 39%) differed significantly among the groups (p=0.047, 0.010 and 0.010, respectively). During the study period, the total injection number (3.5, 4.0 and 5.5) and recurrence rates (19%, 25% and 52%) differed significantly among the groups (p=0.021, 0.006). We could not determine the differences of mean change of BCVA and CRT, although the final BCVA (0.16, 0.29 and 0.58) and foveal atrophy (15%, 22% and 52%) differed significantly (p<0.001, p=0.005). After being controlled by other factors, the duration of CNV was significantly correlated with final BCVA (r=0.318, p=0.002). On multivariate analysis, patient age, duration of CNV, baseline BCVA and CNV size were significantly associated with final BCVA (p<0.001, 0.020, <0.001 and 0.004, respectively). Recurrence was related with duration of CNV, subfoveal choroidal thickness and CNV size (p=0.004, 0.023 and 0.037, respectively).
Conclusions :
Initiation of treatment as soon as possible following the onset of myopic CNV decreased recurrence rates and required injection number and consequently improved visual outcome. The CNV size and the duration of CNV were the main prognostic factors of myopic CNV after anti-VEGF injection. These results supports the hypothesis that early treatment to obtain better visual outcomes and lower recurrence rates in patients with myopic CNV.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.