PACHYCHOROID NEITHER PROMOTES NOR INHIBITS THE FORMATION OF FIBROSIS IN MACULAR NEOVASCULARIZATION

Subretinal fibrosis is a major cause of vision loss during macular neovascularization (MNV) treatment. This study investigated the effect of the pachychoroid phenotype on subretinal fibrosis development after antivascular endothelial growth factor therapy for MNV.

A total of 107 eyes from 107 patients (63 males, 44 females; mean age 72.9 ± 8.8 years) treated with antivascular endothelial growth factor therapy for MNV and followed for at least 4 years were included. Univariate and multivariate analyses identified factors associated with subretinal fibrosis at 4 years.

Subretinal fibrosis developed in 18 eyes (16.8%) after 4 years of therapy. Fibrosis occurred more frequently in eyes with type 2 MNV (44.4%) and subretinal hemorrhage (88.9%) ( P = 0.026 and 0.001, respectively). The incidence of fibrosis did not differ between eyes with and without pachychoroid features (14.8% vs. 18.9%, P = 0.614). Logistic regression identified subretinal hemorrhage, type 2 MNV, and taller pigment epithelium detachment as significant factors ( P = 0.0424, 0.0193, and 0.0149, respectively).

In addition to subretinal hemorrhage and type 2 MNV, taller pigment epithelium detachment was associated with subretinal fibrosis. The pachychoroid phenotype was neither a promoting nor protective factor for fibrosis.