State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
The 7th Affiliated Hospital, Sun Yat-Sen University, ShenZhen, Guangdong, China.
Br J Ophthalmol. 2021 Jan;105(1):103-108. doi: 10.1136/bjophthalmol-2019-315763. Epub 2020 Mar 11.
To assess the incidence, clinical features and predictive risk factors of subretinal fibrosis after treatment of active myopic choroidal neovascularisation (mCNV) with anti-vascular endothelial growth factor (VEGF).
This post-hoc analysis of a randomised controlled trial included a total of 54 patients with active mCNV. The clinical data at baseline, month 3 and month 12 were used. Fundus photography and optical coherence tomography at month 3 were used to determine the presence of subretinal fibrosis after anti-VEGF therapy, and its incidence was calculated. Best-corrected visual acuity (BCVA), Visual Function Questionnaire-25 score, macular integrity index (MI) and their changes were compared between eyes with and without subretinal fibrosis. A logistic regression model was used to evaluate the risk factors of subretinal fibrosis.
Subretinal fibrosis occurred in 22 of 54 eyes with mCNV. Patients with subretinal fibrosis achieved similar BCVA improvement in comparison with those without fibrosis at 3 and 12 months after the treatment; however, they had lower visual acuity, more subfoveal CNV (p=0.002), higher CNV thickness at baseline (p=0.016), larger CNV size (p=0.030), larger leakage area (p=0.021) and higher presence of advanced myopic maculopathy (p=0.035). Age <45 years, BCVA <60 ETDRS letters, and MI index <20 at baseline were the predictors for subretinal fibrosis occurrence in a logistic regression model.
The incidence of subretinal fibrosis after anti-VEGF therapy was 40.7% in eyes with mCNV. Age, baseline BCVA and MI index could serve as predictive risk factors of subretinal fibrosis after anti-VEGF treatment in patients with mCNV.
评估抗血管内皮生长因子（VEGF）治疗活跃性近视脉络膜新生血管（mCNV）后发生视网膜下纤维化的发生率、临床特征和预测风险因素。
这是一项随机对照试验的事后分析，共纳入 54 例活跃性 mCNV 患者。使用基线、第 3 个月和第 12 个月的临床数据。第 3 个月的眼底照相和光学相干断层扫描用于确定抗 VEGF 治疗后是否存在视网膜下纤维化，并计算其发生率。比较有和无视网膜下纤维化眼的最佳矫正视力（BCVA）、视觉功能问卷-25 评分、黄斑完整性指数（MI）及其变化。使用逻辑回归模型评估视网膜下纤维化的风险因素。
54 例 mCNV 眼中有 22 例发生视网膜下纤维化。与无纤维化眼相比，纤维化眼在治疗后 3 个月和 12 个月时的 BCVA 改善相似；然而，它们的视力较低，更靠近中心凹的 CNV（p=0.002），基线时 CNV 厚度较高（p=0.016），CNV 较大（p=0.030），渗漏面积较大（p=0.021），高度近视性黄斑病变更严重（p=0.035）。年龄<45 岁、基线时 BCVA<60 ETDRS 字母和 MI 指数<20 是逻辑回归模型中视网膜下纤维化发生的预测因素。
mCNV 眼抗 VEGF 治疗后视网膜下纤维化的发生率为 40.7%。年龄、基线 BCVA 和 MI 指数可作为 mCNV 患者抗 VEGF 治疗后发生视网膜下纤维化的预测风险因素。
