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Updated: Jan 9, 2026

Author Spotlight: Overcoming Anti-VEGF Resistance Through Advanced Vascular Morphology Assessment in Choroidal Neovascularization
Published on: August 11, 2023
Choroidal changes after antiVEGF in neovascular age-related macular degeneration with type 1 and 3 macular
Francisco de Asís Bartol-Puyal1,2,3, Jorge Sánchez Monroy4,5,6, Martín Puzo Bayod4,5,6
1Miguel Servet University Hospital, Paseo Isabel La Católica, 1-3, 50009, Zaragoza, Spain. franbarpuy@unizar.es.
Purpose:
To analyze choroidal thickness (CT) in patients with neovascular age-related macular degeneration (nAMD) with type 1 macular neovascularization (MNV) and type 3 (or retinal angiomatous proliferation) after antiVEGF treatment for two years.
Methods:
Retrospective study enrolling Caucasian naïve patients with nAMD (type 1 MNV), and patients with type 3 MNV with no other ophthalmological disorders, and without switching treatment. Nine manual CT measurements were performed on optical coherence tomography (OCT) Spectralis (Heidelberg Engineering). Demographic data, smoking, disease activity, and number of injections, among others were recorded. Three visits were analyzed: pretreatment baseline visit, first and last visits with no disease activity.
Results:
53 eyes of 53 patients with type 1 MNV, and 41 eyes of 41patients with type 3 MNV were analyzed. Both groups received the same number of injections (p = 0.282). Type 3 MNV patients showed lower CT (between 143.29 and 174.17μm) than type 1 MNV patients (between 169.91 and 220.17μm) in the baseline visit, but differences disappeared in first and last visits. Choroidal thinning was only observed in type 1 MNV patients between baseline and first visit (p < 0.05). In the las visit, they had a CT between 87 and 96% of baseline measurement. No other influencing factor was detected.
Conclusions:
Patients with nAMD (type 1 MNV) have higher CT than patients with type 3. However, patients with type 1 MNV experience significant choroidal thinning, and CT is similar in both groups after antiVEGF treatment. Smoking, type of drusen or other OCT features have no influence in this reduction.
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