Predictive Factors for Macular Atrophy in Patients with Treated Myopic Macular Neovascularization

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Imaging

Background:

• Macular atrophy is an advanced stage of myopic maculopathy.
• Myopic macular neovascularization (mMNV) is a common cause of vision impairment in high myopia.
• Understanding atrophy progression is crucial for managing vision loss.

Purpose of the Study:

• To identify predictive factors for chorioretinal atrophy (CRA) growth in patients with treated mMNV.
• To analyze the relationship between baseline characteristics, treatment regimens, and atrophy progression.
• To assess the impact of atrophy on final visual acuity.

Main Methods:

• Retrospective study of 98 eyes from 83 patients with mMNV followed for at least 2 years.
• Primary outcomes included increase in CRA and final best-corrected visual acuity (fBCVA).
• Analysis of treatment regimens (3+pro re nata vs. treat and extend) and intravitreal injections (IVI).

Main Results:

• Mean CRA growth was 0.48 mm²/year, significantly associated with worse fBCVA in subfoveal atrophy.
• Baseline CRA was the major determinant of final CRA size (β=0.90).
• Uninterrupted treat and extend regimens showed a higher CRA growth rate (0.95 mm²/year).

Conclusions:

• Baseline atrophic area is the primary predictor of final macular atrophy.
• Initial subfoveal choroidal thickness and treatment intensity (IVI) may influence atrophy growth.
• Macular atrophy following mMNV results in irreversible visual loss, emphasizing the need for predictive factor identification.