Riccardo Sacconi MD, PhD , Paolo Forte MD , Giulia Corradetti MD , Eliana Costanzo MD , Vittorio Capuano MD , Elodie Bousquet MD , Federico Beretta MD , Serena Iannuzzi MD , Maria Sole Polito MD , Massimo Nicolò MD , Mariacristina Parravano MD , Eric Souied MD, PhD , David Sarraf MD , SriniVas Sadda MD , Francesco Bandello MD , Giuseppe Querques MD, PhD
{"title":"Type 3 Macular Neovascularization in Age-related Macular Degeneration","authors":"Riccardo Sacconi MD, PhD , Paolo Forte MD , Giulia Corradetti MD , Eliana Costanzo MD , Vittorio Capuano MD , Elodie Bousquet MD , Federico Beretta MD , Serena Iannuzzi MD , Maria Sole Polito MD , Massimo Nicolò MD , Mariacristina Parravano MD , Eric Souied MD, PhD , David Sarraf MD , SriniVas Sadda MD , Francesco Bandello MD , Giuseppe Querques MD, PhD","doi":"10.1016/j.oret.2024.11.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To identify baseline OCT predictors of the 3-year macular atrophy (MA) development for type 3 (T3) macular neovascularization (MNV) secondary to neovascular age-related macular degeneration (nAMD) treated by anti-VEGF therapy.</div></div><div><h3>Design</h3><div>Multicenter, retrospective, longitudinal study.</div></div><div><h3>Participants</h3><div>We included patients with treatment-naive T3 MNV secondary to nAMD at baseline, treated with anti-VEGF during a 3-year follow-up.</div></div><div><h3>Methods</h3><div>Patients were identified from 6 retinal referral institutions: (1) San Raffaele University, Milan, Italy; (2) University of Genova, Genova, Italy; (3) Doheny Eye Institute, Los Angeles; (4) Stein Eye Institute, Los Angeles; (5) University of Paris Est, Creteil, France; and (6) Istituto di Ricovero e Cura a Carattere Scientifico Bietti Foundation, Rome, Italy. Several baseline predictors of 3-year MA area were analyzed based on structural OCT and demographics.</div></div><div><h3>Main Outcome Measures</h3><div>Multivariate analysis to identify baseline independent predictors of the 3-year MA development for T3 MNV secondary to nAMD treated by anti-VEGF therapy.</div></div><div><h3>Results</h3><div>We included 131 eyes of 131 patients (mean age, 80 ± 6 years; 81% females). Best-corrected visual acuity was 0.49 ± 0.40 logarithm of the minimum angle of resolution (logMAR) at the baseline and significantly decreased to 0.59 ± 0.43 logMAR at the end of 3-year follow-up (<em>P</em> < 0.001). Patients were treated with 11 ± 6 anti-VEGF injections and developed atrophy in 75% of cases (from 18% at the baseline). Eyes that developed 3-year MA were treated with a significantly lower number of injections compared with eyes without MA (9.9 ± 5.5 vs. 14.7 ± 7.2 injections, <em>P</em> < 0.001). The most relevant independent predictors at baseline of MA area at 3-year follow-up were: area of MA at baseline (<em>P</em> < 0.001), age-related macular degeneration phenotype (presence of reticular pseudodrusen) (<em>P</em> = 0.017), baseline presence of nascent geographic atrophy (<em>P</em> = 0.008), and the baseline presence of subretinal hyperreflective material (<em>P</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>Macular atrophy development is a frequent complication of T3 MNV treated with anti-VEGF injections. Several factors could be considered baseline predictors of atrophy development during the anti-VEGF treatment.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 6","pages":"Pages 546-555"},"PeriodicalIF":5.7000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology. Retina","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468653024005414","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose
To identify baseline OCT predictors of the 3-year macular atrophy (MA) development for type 3 (T3) macular neovascularization (MNV) secondary to neovascular age-related macular degeneration (nAMD) treated by anti-VEGF therapy.
Design
Multicenter, retrospective, longitudinal study.
Participants
We included patients with treatment-naive T3 MNV secondary to nAMD at baseline, treated with anti-VEGF during a 3-year follow-up.
Methods
Patients were identified from 6 retinal referral institutions: (1) San Raffaele University, Milan, Italy; (2) University of Genova, Genova, Italy; (3) Doheny Eye Institute, Los Angeles; (4) Stein Eye Institute, Los Angeles; (5) University of Paris Est, Creteil, France; and (6) Istituto di Ricovero e Cura a Carattere Scientifico Bietti Foundation, Rome, Italy. Several baseline predictors of 3-year MA area were analyzed based on structural OCT and demographics.
Main Outcome Measures
Multivariate analysis to identify baseline independent predictors of the 3-year MA development for T3 MNV secondary to nAMD treated by anti-VEGF therapy.
Results
We included 131 eyes of 131 patients (mean age, 80 ± 6 years; 81% females). Best-corrected visual acuity was 0.49 ± 0.40 logarithm of the minimum angle of resolution (logMAR) at the baseline and significantly decreased to 0.59 ± 0.43 logMAR at the end of 3-year follow-up (P < 0.001). Patients were treated with 11 ± 6 anti-VEGF injections and developed atrophy in 75% of cases (from 18% at the baseline). Eyes that developed 3-year MA were treated with a significantly lower number of injections compared with eyes without MA (9.9 ± 5.5 vs. 14.7 ± 7.2 injections, P < 0.001). The most relevant independent predictors at baseline of MA area at 3-year follow-up were: area of MA at baseline (P < 0.001), age-related macular degeneration phenotype (presence of reticular pseudodrusen) (P = 0.017), baseline presence of nascent geographic atrophy (P = 0.008), and the baseline presence of subretinal hyperreflective material (P = 0.002).
Conclusions
Macular atrophy development is a frequent complication of T3 MNV treated with anti-VEGF injections. Several factors could be considered baseline predictors of atrophy development during the anti-VEGF treatment.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.