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Updated: Sep 9, 2025

Author Spotlight: Overcoming Anti-VEGF Resistance Through Advanced Vascular Morphology Assessment in Choroidal Neovascularization
Published on: August 11, 2023
CHANGES IN WIDEFIELD CHOROIDAL THICKNESS AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NEOVASCULAR
Sorako Wakugawa1, Naoya Imanaga, Nobuhiro Terao
1Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Purpose:
This study aimed to investigate changes in choroidal thickness using widefield optical coherence tomography after anti-vascular endothelial growth factor (VEGF) therapy for neovascular age-related macular degeneration (AMD).
Methods:
We examined 69 patients with unilateral neovascular AMD. All patients underwent three monthly intravitreal injections of anti-VEGF agents. Widefield choroidal thickness within an 18-mm circular grid centered on the fovea, subdivided into nine areas, was evaluated at baseline and at 3 months.
Results:
Forty-two and 27 patients were classified into the AMD and pachychoroid neovasculopathy (PNV) groups, respectively. At 3 months, the treated eyes in both groups showed significantly and extensively reduced choroidal thickness ( P < 0.01 for all areas). The untreated fellow eyes in the PNV group also showed decreased choroidal thickness at 3 months ( P < 0.05 for all areas). Complete retinal fluid resolution was significantly associated with a greater decrease ratio of choroidal thickness in the PNV group ( P < 0.05 for all areas).
Conclusion:
Anti-VEGF therapy for neovascular AMD led to extensively decreased choroidal thickness. In patients with PNV, a greater decrease in overall choroidal thickness appeared to be associated with more effective resolution of retinal fluid. Observation of widefield choroidal thickness may be important for the management of neovascular AMD.
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