Lenhof Scott, Kodjikian Laurent, Gascon Pierre, Gadiollet Etienne, Feldman Audrey, De Bats Flore, Wolff Benjamin, Pradat Pierre, Mathis Thibaud
Ophthalmology Department, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
MATEIS Laboratory, UMR-CNRS 5510, INSA, University of Claude Bernard Lyon 1, Villeurbanne, France.
Acta Ophthalmol. 2025 Mar;103(2):e104-e117. doi: 10.1111/aos.16759. Epub 2024 Sep 25.
To assess subretinal fibrosis (SF) occurrence in neovascular age-related macular degeneration (nAMD), according to macular neovascularisation (MNV) subtypes.
A Retrospective national multi centre cohort study included eyes with naive nAMD. Main outcome measures were, according to MNV subtypes, cumulative incidence for SF, risk factors, and best corrected visual acuity (BCVA) for 36 months.
Four hundred and twenty eyes were included. Cumulative incidence of SF was 34.3% at 1 year, 39.0% at 2 years and 50.6% at 3 years. In multivariable analysis, Type 2 and mixed type 1 and 2 MNV were associated (p < 0.001) with a more frequent and rapid development of SF (respectively 85.5% and 81.0% at 1 year, then 95.8% and 93.1% at 3 years) than Types 1 and 3 (respectively 11.3% and 3.6% at 1 year, then 22.9% and 12.7% at 3 years). In Type 2 and mixed type 1 and 2 MNV combined, at baseline a worse BCVA (p = 0.02) and a higher maximal subretinal hyperreflective material (SHRM) thickness (p = 0.005) were associated with SF development at 3 years. In Type 1 MNV, the presence at baseline of intraretinal fluid (IRF) (p = 0.007) or SHRM (p < 0.001) and a higher percentage of visits with IRF (p < 0.001) or with SHRM (p < 0.001) were associated with SF occurrence. For Type 3 MNV, only a higher percentage of visits with SHRM (p = 0.001) was associated with SF. Including all MNV subtypes, eyes with a worse BCVA at baseline were associated with SF development (p < 0.001). Conversely, presence of SF at 3 years was associated with a worse baseline BCVA (p < 0.001).
Occurrence of SF differs when considering apart MNV subtypes.
根据黄斑新生血管（MNV）亚型评估新生血管性年龄相关性黄斑变性（nAMD）中视网膜下纤维化（SF）的发生情况。
一项回顾性全国多中心队列研究纳入了初发nAMD患者的眼睛。主要观察指标为根据MNV亚型划分的SF累积发病率、危险因素以及36个月时的最佳矫正视力（BCVA）。
共纳入420只眼睛。SF的累积发病率在1年时为34.3%，2年时为39.0%，3年时为50.6%。在多变量分析中，2型以及1型和2型混合型MNV与SF更频繁且快速的发展相关（p < 0.001）（1年时分别为85.5%和81.0%，3年时分别为95.8%和93.1%），高于1型和3型（1年时分别为11.3%和3.6%，3年时分别为22.9%和12.7%）。在2型以及1型和2型混合型MNV合并组中，基线时较差的BCVA（p = 0.02）和更高的视网膜下高反射物质（SHRM）最大厚度（p = 0.005）与3年时SF的发生相关。在1型MNV中，基线时视网膜内液（IRF）（p = 0.007）或SHRM（p < 0.001）的存在以及更高比例的伴有IRF（p < 0.001）或SHRM（p < 0.001）的就诊与SF的发生相关。对于3型MNV，只有更高比例的伴有SHRM的就诊（p = 0.001）与SF相关。纳入所有MNV亚型，基线时BCVA较差的眼睛与SF的发展相关（p < 0.001）。相反，3年时SF的存在与较差的基线BCVA相关（p < 0.001）。
分别考虑MNV亚型时，SF的发生情况有所不同。
