Clinical characteristics and visual recovery in lost-to-follow-up myopic choroidal neovascularization treated with...

To identify sociodemographic and clinical factors associated with best-corrected visual acuity (BCVA) restoration at the visit after lost to follow-up (LTFU) in patients with myopic choroidal neovascularization (mCNV) treated with antivascular endothelial growth factor intravitreal injections (IVI).

A multicentre, retrospective cohort study was conducted in China of mCNV patients receiving injections who were LTFU >6 months. Data were collected from baseline visit, pre-LTFU, initial post-LTFU visit and 6 months post-LTFU, and the final visit. Logistic regression analyses assessed associations between sociodemographic/clinical factors and BCVA restoration.

The study included 1155 LTFU patients with mCNV (mean (SD) age: 54 (16) years; 61.6% female), with 66.6% achieving BCVA restoration at the initial post-LTFU visit after LTFU (mean(SD) duration: 315 (154) days. Patients with BCVA restoration were younger (p=0.004), more often from eastern China (p=0.022), and had shorter LTFU duration (p=0.013). Stratification by pre-LTFU BCVA showed that patients with BCVA ≥20/40 had lower restoration odds (OR 0.65, 95% CI 0.44 to 0.96; p=0.032) compared with those with BCVA <20/200. BCVA decline was associated with increased central subfield thickness(CST) (OR 1.52, 95% CI 1.15 to 2.01; p=0.004). Among 223 patients with ≥6 months post-LTFU, those with initial post-LTFU CST >280 µm had higher BCVA restoration odds (OR 1.98, 95% CI 1.02 to 3.92; p=0.046).

Better pre-LTFU BCVA (≥20/40) increased post-LTFU deterioration risk (associated with progressive CST thickening), while elevated post-LTFU CST (>280 µm) predicted higher BCVA restoration odds in patients with sustained follow-up, supporting CST-guided monitoring and early intervention for high-risk groups.