Incidence and enlargement rate of myopic macular neovascularization-related atrophy in highly myopic eyes

Summary

Myopic MNV with anti-VEGF atrophy develops in one-third within 2 years. Retrospective 44 eyes.

Abstract

Purpose: To investigate the incidence and enlargement rate of myopic macular neovascularization (MNV)-related atrophy in highly myopic eyes.

Methods: This retrospective observational study included highly myopic eyes treated for myopic MNV followed for ≥24 months. Atrophy was defined as a retinal pigment epithelium disruption with hypertransmission on spectral-domain optical coherence tomography. The atrophic area detected on spectral-domain optical coherence tomography was delineated manually on en-face infrared images and measured with a built-in feature. Only eyes with tessellated fundus or diffuse atrophy at baseline were included. Eyes with preexisting retinal pigment epithelium atrophy, including patchy/MNV-related atrophy, were excluded.

Results: Among 473 MNV eyes, 44 eyes of 40 patients (mean follow-up: 75.4 ± 37.7 months) met the inclusion criteria. Fifteen eyes (34.1%) developed MNV-related atrophy 23.37 ± 18.02 months after MNV onset. The atrophy area increased from 0.38 ± 0.67 mm 2 at diagnosis to 1.08 ± 1.45 mm 2 after 45.77 ± 26.45 months ( P = 0.011), corresponding to an enlargement rate of 0.22 ± 0.25 mm 2 /year. Larger MNV diameter and male gender were associated with MNV-related atrophy development.

Conclusion: In highly myopic eyes without preexisting retinal pigment epithelium atrophy, one third showed MNV-related atrophy within 2 years of MNV onset. The atrophy enlargement rate was 0.22 ± 0.25 mm 2 /year, highlighting the importance of close monitoring.