Outcomes and risk of reactivation of myopic CNV: Multi-Centre Study with long term follow up

Abstract

Purpose : Long term outcomes and risk of reactivation of myopic choroidal neovascularisation (mCNV) are poorly understood. This study describes the treatment patterns, risk of reactivation and visual outcomes over ten years in a large cohort of patients.

Methods : Treatment-naïve eyes receiving at least one intravitreal anti-vascular endothelial growth factor (VEGF) injections for mCNV were included in the study. Data were generated during routine clinical care) between 09/2008 and 12/2018 utilising Medisoft Electronic Patient Record (EPR) data from 27 NHS sites in the UK. Main outcome measures included visual acuity (VA), number of injections, number of reactivations and number of visits. Reactivations were defined as between 95 to 97.5 centile of distribution of injection interval in this study cohort.

Results : A total of 385 eyes of 380 patients receiving 1,822 injections were included. The mean age was 61.7 years old and the Female:Male was 2.25:1. Loess regression of Visual Acuity (VA) vs times 0, 6, 12, 24, 36, 48, and 60 months was 61, 64, 66, 66, 64, 61,and 59 (letters) . The end of an mCNV activity “reactivation” was determined to be 12 weeks (just below 97.5 centile of distribution of injection interval in this study cohort).
The mean number of injections was 3.12 injections during their first reactivation episode, which reduces to 2.04, 2.27, 2.36, 1.95, and 1.6 at their 2nd, 3rd, 4th, 5th, and 6th reactivation episode, respectively.

Conclusions : Our findings show that in the first four years of treatment, the VA is shown to have improved. However, past the fourth year, the VA steadily reduces. The data guides the temporal definition of the end of an mCNV reactivation and the number of treatments and the likelihood of further reactivations of disease activity occurring. These data will guide the counselling of patients and follow up intervals scheduling.

This is a 2021 ARVO Annual Meeting abstract.