Observational studyGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Analysis of macular atrophy in type 3 macular neovascularization cases: a follow-up of over 7 years.
Observational study in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
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Abstract
purposeTo investigate the long-term incidence and progression of macular atrophy (MA) in patients with type 3 macular neovascularization (MNV) undergoing anti-vascular endothelial growth factor (VEGF) therapy and to identify associated clinical factors.
methodsThis retrospective observational study included 23 eyes from 19 Japanese patients diagnosed with treatment-naïve type 3 MNV. Patients received anti-VEGF therapy and were followed for a mean duration of 8.9 ± 1.7 years (median 8.8 years, range 7.0–13.2 years). MA was assessed at baseline, 1–2 years, and the final visit using fundus autofluorescence (FAF), near-infrared reflectance (NIR), and spectral-domain optical coherence tomography (SD-OCT). MA size, progression rate, subretinal drusenoid deposits (SDD) regression, and subfoveal choroidal thickness (SCT) were evaluated.
resultsMA developed in 87% of eyes, with a significant increase in lesion size from 0.78 ± 1.50 mm² at year 1–2 to 9.62 ± 11.1 mm² at the final visit (p < 0.001). MA progression accelerated after year 2. A significant negative correlation was observed between baseline SCT and final MA size (r = -0.42, p < 0.05). SDD regression was associated with faster MA growth. No significant association was found between MA progression and anti-VEGF injection number, recurrence frequency, or PDT history. Visual acuity declined significantly over time and correlated with final MA size (r = 0.59, p < 0.01).
conclusionMA in type 3 MNV continued to enlarge over nearly 9 years of anti-VEGF treatment. Atrophy progression was linked to choroidal thinning and SDD regression, rather than treatment burden, highlighting the need for phenotype-based risk stratification and alternative therapeutic strategies.
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