Prognosis of visual acuity and retinal atrophy in patients with myopic choroidal neovascular membrane treated with anti-vascular endothelial growth factor

Abstract

Purpose : To compare the visual acuity and retinal atrophy of patients with myopic choroidal neovascular membrane (mCNVM) at the baseline and endpoint of observation during their treatment with anti-vascular endothelial growth factor (VEGF)

Methods : The clinical data of patients with mCNVM who were treated with anti-VEGF by a retinal specialist at the Kensington Eye Institute in Toronto, Ontario, Canada between November 2019 and November 2022 were retrospectively reviewed. The eyes with drusen, trauma, and vitreoretinal surgeries were excluded. The eyes with stable or increased central subfield thickness (CST) on optical coherent tomography (OCT) imaging were separated into two groups. Using the length tool of the OCT software, the retinal atrophic area (AA) was measured on the scanning laser ophthalmoscopy images. The patterns of the anti-VEGF vitreous cavity injection (IVT) between two groups were compared with the numbers of IVT per year and percentage of months free from IVT to the total months of observation. The visual acuity (VA) and AA at baseline and endpoint of the observation period, were analyzed. The p-values were calculated using a chi-square for categorical variables and a t-test for continuous variables. A significant difference was considered if the p-value ≤0.05.

Results : Of the 17 patients (20 eyes), the bilateral mCNVM was diagnosed in 3 patients. The average age of patients was 63.6 years. The ratio of females to males was 10 to 7. The history of mCNVM varied from 15 to 75 months. Of the total of 20 eyes, 11 eyes had stable CST whereas 9 eyes had increased CST. Compared to the baselines, the endpoint VA of eyes was shown to increase but the difference was not significant (letter scores, 57.8 vs 61.7, p= 0.33). Overall, the endpoint AA of eyes was enlarged but the difference was not significant (3319.6 µm vs 3561.1 µm, p=0.76) with the treatment of anti-VEGF. The numbers of IVT per year for the two groups with mCNVM were not significantly different (2.85 vs 2.70, p=0.91). The IVT free periods were accounted for 74.6% and 66.6% of the observation duration for the two groups respectively and there was no significant difference (p=0.09).

Conclusions : Regardless of the eyes with increased CST, in the entire mCNVM cohort, VA and AA could be maintained under the anti-VEGF regimen over the longitudinal observation.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.