{"title":"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。","authors":"Xiangjun She, Qiwei Cai, Wangjing Yao, Shixin Zhao, Zhe Lv, Suyan Shan, Jiwei Tao, Yun Zhang","doi":"10.1186/s40662-025-00450-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>Submacular DCV is associated with poor therapeutic response to anti-VEGF therapy and an increased risk of SF in patients with mCNV.</p>","PeriodicalId":12194,"journal":{"name":"Eye and Vision","volume":"12 1","pages":"32"},"PeriodicalIF":4.0000,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335765/pdf/","citationCount":"0","resultStr":"{\"title\":\"Myopic choroidal neovascularization with dilated choroid vessels is prone to progression into subretinal fibrosis following anti-vascular endothelial growth factor therapy: a retrospective study.\",\"authors\":\"Xiangjun She, Qiwei Cai, Wangjing Yao, Shixin Zhao, Zhe Lv, Suyan Shan, Jiwei Tao, Yun Zhang\",\"doi\":\"10.1186/s40662-025-00450-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>Submacular DCV is associated with poor therapeutic response to anti-VEGF therapy and an increased risk of SF in patients with mCNV.</p>\",\"PeriodicalId\":12194,\"journal\":{\"name\":\"Eye and Vision\",\"volume\":\"12 1\",\"pages\":\"32\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-08-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335765/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Eye and Vision\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s40662-025-00450-4\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Eye and Vision","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40662-025-00450-4","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Myopic choroidal neovascularization with dilated choroid vessels is prone to progression into subretinal fibrosis following anti-vascular endothelial growth factor therapy: a retrospective study.
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.
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.
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