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Incidence, predictors and re-treatment outcomes of recurrent myopic choroidal neo-vascularization

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  • Mukesh Jain
  • Raja Narayanan
  • Priya Jana
  • Ashik Mohamed
  • Rajiv Raman
  • Pavan Verkicharla
  • Srikanta Kumar Padhy
  • Anthony Vipin Das
  • Jay Chhablani

Abstract

Objectives: To evaluate incidence, predictors, and re-treatment outcome of recurrent myopic choroidal neovascularization (m-CNV). Methods: Retrospective consecutive observational series. From year 2014 to 2019, 167 eyes of 167 patients of treatment naïve m-CNV were enrolled. 59 and 108 eyes were treated with intra-vitreal ranibizumab and bevacizumab mono-therapy, respectively. Recurrence was defined as re-appearance of CNV activity, confirmed on optical coherence tomography (OCT) after at least 3 months of cessation of anti-VEGF therapy. Incidence of recurrence, predictors and re-treatment outcomes were studied. Results: Overall, mean age and spherical equivalence (SE) was 47.95 ± 14.72 years and -12.19 ± 4.93 D respectively. Males constituted 50.9%. 44 eyes (26.4%) had a recurrence during a mean follow up of 16.5 ± 12.86 months. Kaplan-Meier survival analysis showed the risk of recurrence was 8, 26 and, 33.6% at 6, 12 and 18 months, respectively. Age (p = 0.511), gender (p = 0.218), SE (p = 0.092), anti-VEGF (p = 0.629) and baseline BCVA (p = 0.519) did not influence recurrence. Number of injections administered to control the disease in the first episode was the only significant predictor of recurrence (Cox Proportional Hazard Ratio 2.89–3.07, 95% Confidence Interval: 1.28–7.45; p = 0.005). At 12 months, eyes requiring one injection in first episode had a recurrence rate of 12% versus 45% in eyes requiring 3 or more injections in the first episode. A mean number of 1.9 additional injections per eye was needed during re-treatment. Final BCVA in the recurrence group was similar to that of non-recurrence group (0.53 ± 0.40 versus 0.55 ± 0.36 LogMAR; p = 0.755). Baseline BCVA (p = 0.0001) was the only predictor of final visual outcome irrespective of anti-VEGF drug (p = 0.38). Conclusion: Eyes requiring greater number of injections for disease control in first episode are “at risk” of early m-CNV recurrence. However, recurrence does not adversely affect visual outcome, if treated adequately.

Suggested Citation

  • Mukesh Jain & Raja Narayanan & Priya Jana & Ashik Mohamed & Rajiv Raman & Pavan Verkicharla & Srikanta Kumar Padhy & Anthony Vipin Das & Jay Chhablani, 2022. "Incidence, predictors and re-treatment outcomes of recurrent myopic choroidal neo-vascularization," PLOS ONE, Public Library of Science, vol. 17(7), pages 1-10, July.
    • Handle: RePEc:plo:pone00:0271342
    DOI: 10.1371/journal.pone.0271342
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