Recurrence timing and visual outcomes of recurrent myopic choroidal neovascularization after anti-VEGF therapy

To compare clinical characteristics and visual outcomes according to recurrence timing in eyes with myopic choroidal neovascularization (CNV) following anti-vascular endothelial growth factor (anti-VEGF) therapy.

This retrospective cohort study included eyes with treatment-naïve myopic CNV that achieved complete resolution after initial anti-VEGF therapy. To specifically evaluate the impact of recurrence timing, analyses were restricted to eyes that developed recurrence, which were categorized as early (< 12 months) or late (≥ 12 months). Baseline characteristics, multimodal imaging features, treatment profiles, and recurrence-specific parameters were compared. Longitudinal changes in best-corrected visual acuity (BCVA) were analyzed using linear mixed-effects models, and factors associated with the final BCVA were evaluated using multivariable linear regression.

Of the 79 eyes, 32 (40.5%) experienced recurrence during the mean follow-up of 36.9 ± 23.7 months (early: 15 eyes; late: 17 eyes). The early recurrence group exhibited a significantly longer axial length (p = 0.019); other baseline features and treatment profiles were similar between groups. At recurrence, subretinal hyperreflective material height was significantly greater in the late recurrence group (p = 0.041). Both groups showed visual improvement after initial treatment, without a significant difference in BCVA at any predefined time point. Baseline BCVA was the only independent predictor for final BCVA (β = 0.46, p = 0.039); no significant association between recurrence timing and visual outcomes was detected.

Visual outcomes were comparable between early and late recurrences of myopic CNV. Baseline BCVA was the strongest factor associated with long-term visual outcome, whereas no association between recurrence timing and visual outcomes was detected in this cohort.