Association between choroidal morphology and anti-vascular endothelial growth factor treatment outcome in myopic...

To investigate associations between outcome of anti-vascular endothelial growth factor (VEGF) therapy and choroidal morphology in eyes with myopic choroidal neovascularization (CNV).

Fifty-two eyes of 46 patients with myopic CNV received a single intravitreal anti-VEGF injection, followed by as-needed injections. Baseline choroidal thickness was measured at the fovea and 1.5 and 3 mm nasal, temporal, superior, and inferior to the fovea using enhanced depth imaging optical coherence tomography. Measurements were compared between eyes with and without CNV resolution after a single injection and between those with and without CNV recurrence within 1 year of initial injection. Associations between treatment outcomes and morphologic or clinical factors were assessed using regression analyses.

Patients received 1.8 ± 1.3 intravitreal injections during follow-up. Eyes with CNV resolution after a single anti-VEGF injection had a significantly thicker inferior choroid than those without resolution (67.3 ± 32.9 vs. 44.5 ± 17.6 μm, P = 0.002). The subfoveal choroid was thinner in eyes with recurring CNV than in those without recurrence (35.7 ± 23.7 vs. 52.0 ± 20.8 μm, P = 0.029). Associations were found between inferior choroidal thickness and CNV resolution (P = 0.019) and between subfoveal choroidal thickness and 1-year recurrence rates (P = 0.016). Adjusted odds ratios were 9.1 for CNV resolution with an inferior choroidal thickness >49 μm and 5.6 for recurrence within 1 year with a subfoveal choroidal thickness ≤47.5 μm.

A thinner subfoveal/inferior choroid at baseline may indicate poor anatomic outcome after intravitreal anti-VEGF treatment in eyes with myopic CNV.