Subfoveal Choroidal Thickness Changes Following Anti-Vascular Endothelial Growth Factor Therapy in Myopic Choroidal Neovascularization

摘要

Purpose: To investigate subfoveal choroidal thickness (SFCT) changes following intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy and to identify clinical and choroidal parameters associated with visual outcome in eyes with myopic choroidal neovascularization (CNV). Methods: In 60 eyes of 54 patients who were treated with anti-VEGF injections for myopic CNV, SFCT was measured using enhanced depth imaging optical coherence tomography at baseline, at 1, 3, and 6 months after initial anti-VEGF therapy, and at the final visit. Subfoveal choroidal thickness was compared between visits in subgroups separated based on anatomic outcome, recurrence, or resolution. Univariate and multivariate regression analyses were performed to identify factors associated with final best-corrected visual acuity (BCVA). Results: At baseline, the mean SFCT was 47.6 ?± 24.7 ??m, significantly lower than that of the contralateral eyes (59.8 ?± 34.4 ??m, P = 0.022). The thickness significantly decreased to 45.2 ?± 24.0 ??m (P = 0.027) 1 month after the anti-VEGF therapy. In the recurrent cases, the SFCT significantly increased from 46.1 ?± 25.5 ??m at month 1 to 52.4 ?± 25.8 ??m at the time of recurrence (P = 0.020); however, no significant change in the SFCT was noted in the nonrecurrent cases. In the regression analyses, the baseline BCVA (P 0.001) and central macular thickness (CMT; P = 0.003) significantly correlated with the final BCVA, whereas SFCT or its change was not significantly associated with final BCVA. Conclusions: Subfoveal choroidal thicknesss significantly decreased following anti-VEGF therapy in myopic CNV, but showed a subsequent increase in recurrence. Subfoveal choroidal thickness may reflect disease activity and aid decision making regarding retreatment in myopic CNV for recurrent cases.