Abstract
Purpose :
Choroidal neovascularization (CNV) is a frequent and sight-threatening complication in high myopia. The anti-vascular endothelial growth factor (VEGF) therapy is the current standard of treatment in newly diagnosed myopic CNV. However, after exudation is resolved, patients may experience recurrences that were demonstrated to significantly impact the long-term visual outcomes. The aim of this study is to assess the relationship of demographics, clinical characteristics and structural optical coherence tomography (OCT) findings to disease recurrence in a cohort of patients with newly diagnosed myopic CNV.
Methods :
In this IRB-approved retrospective analysis, we collected data from 64 participants (64 eyes) with successfully treated myopic CNV who had obtained resolution of exudation after treatment (study baseline) and with 3 years of regular follow-ups. At baseline, several OCT qualitative features and quantitative measurements were graded by two readers and included in the analysis. Main outcome measures included incidence of disease recurrence and hazard ratio (HR) for demographics, clinical characteristics and OCT risk factors.
Results :
At month 36, 40 eyes (62.5%) developed disease recurrence (active CNV). Multivariate linear regression analysis revealed that final visual acuity (at 36 months - dependent variable) was associated with visual acuity at baseline visit (p<0.0001), baseline size of patchy atrophy (p=0.010), baseline subfoveal choroidal thickness (p=0.008), baseline maximum CNV height and width (p=0.011 and p=0.003), and recurrence of CNV exudation (p=0.007).
The following factors were associated with an increased risk of disease recurrence: size of patchy atrophy had an HR of 1.14 (95% CI, 1.01-1.29; p=0.036); maximum CNV width had an HR of 1.02 (95% CI, 1.01-1.04; p<0.0001).
Conclusions :
We identified OCT risk factors for the disease recurrence in eyes with successfully treated myopic CNV. Assuming that disease recurrence is a sight-threatening event, our findings may help in the identification of high-risk patients and eventually ameliorate their outcome.
This is a 2021 ARVO Annual Meeting abstract.