Myopic choroidal neovascularization with dilated choroid vessels is prone to progression into subretinal fibrosis following anti-vascular endothelial growth factor therapy: a retrospective study.

IF 4 1区医学 Q1 OPHTHALMOLOGY

Eye and Vision Pub Date : 2025-08-10 DOI:10.1186/s40662-025-00450-4

Xiangjun She, Qiwei Cai, Wangjing Yao, Shixin Zhao, Zhe Lv, Suyan Shan, Jiwei Tao, Yun Zhang

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Abstract

Background: This retrospective study aimed to identify risk factors for subretinal fibrosis (SF) and evaluate the response to anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with myopic choroidal neovascularization (mCNV), with a specific focus on the role of dilated choroidal vessels (DCVs) in disease progression.

Methods: In this retrospective study, patients with high myopia (spherical equivalent < -6.0 D, pathological myopia, Asian ethnicity) and active mCNV lesions, diagnosed between 2021 to 2023, were evaluated. The location of DCVs and mCNV was assessed, and macular thickness, submacular choroid thickness, best-corrected visual acuity, CNV area, and flow density were measured at baseline and during follow-up. The presence of posterior staphyloma was evaluated at baseline. SF around the mCNV was evaluated lesions during follow-up. The time to SF detection was recorded using survival analysis. Risk factors for SF were analyzed using Kaplan-Meier and multivariable Cox regression analyses.

Results: A total of 46 eyes from 46 patients were included, with a mean age of 54.17 ± 14.37 years, and a baseline spherical equivalent of 12.36 ± 3.21 D. The logarithm of the minimum angle of resolution for the mean visual acuity was 0.70 (0.40-1.30), and the mean macular thickness was 313.11 ± 63.57 μm at baseline. DCV was detected in 29 of the 46 eyes (63.0%), and the median time to detect SF was 43.41 [95% confidence interval (CI): 37.27-49.55] months. Multivariable Cox regression analysis identified submacular DCV [hazard ratio (HR): 14.93, 95% CI: 5.72-38.91, P < 0.001) and absence of posterior staphyloma (HR: 43.48, 95% CI: 12.15-156.32, P = 0.002) as independent predictors of SF. The presence of DCV under the fovea compared to the peripheral zone achieved a poorer therapeutic response and was prone to progress to SF after anti-VEGF therapy (P = 0.041).

Conclusions: Submacular DCV is associated with poor therapeutic response to anti-VEGF therapy and an increased risk of SF in patients with mCNV.

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近视脉络膜新生血管伴脉络膜血管扩张在抗血管内皮生长因子治疗后容易进展为视网膜下纤维化：一项回顾性研究。

背景：本回顾性研究旨在确定近视脉络膜新生血管（mCNV）患者视网膜下纤维化（SF）的危险因素，并评估抗血管内皮生长因子（anti-VEGF）治疗的反应，特别关注扩张的脉络膜血管（DCVs）在疾病进展中的作用。结果：纳入46例患者共46只眼，平均年龄54.17±14.37岁，基线球当量为12.36±3.21 d，平均视力最小分辨角的对数为0.70(0.40 ~ 1.30)，基线时平均黄斑厚度为313.11±63.57 μm。46只眼中有29只（63.0%）检测到DCV， SF检测的中位时间为43.41个月[95%可信区间（CI）： 37.27 ~ 49.55]。多变量Cox回归分析确定黄斑下DCV[危险比（HR）： 14.93, 95% CI: 5.72-38.91， P]结论：黄斑下DCV与mCNV患者抗vegf治疗反应差和SF风险增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Eye and Vision OPHTHALMOLOGY-

CiteScore

8.60

自引率

2.40%

发文量

审稿时长

15 weeks

期刊介绍： Eye and Vision is an open access, peer-reviewed journal for ophthalmologists and visual science specialists. It welcomes research articles, reviews, methodologies, commentaries, case reports, perspectives and short reports encompassing all aspects of eye and vision. Topics of interest include but are not limited to: current developments of theoretical, experimental and clinical investigations in ophthalmology, optometry and vision science which focus on novel and high-impact findings on central issues pertaining to biology, pathophysiology and etiology of eye diseases as well as advances in diagnostic techniques, surgical treatment, instrument updates, the latest drug findings, results of clinical trials and research findings. It aims to provide ophthalmologists and visual science specialists with the latest developments in theoretical, experimental and clinical investigations in eye and vision.