Comparison of Real-world Treatment Outcomes between Type 1 and Type 2 Choroidal Neovascularization

Abstract

Purpose: We compared clinical outcomes following 36 months of treatment with anti-vascular endothelial growth factor (VEGF) therapy in patients with exudative age-related macular degeneration. These patients were classified by the location of choroidal neovascularization (CNV) with respect to the retinal pigment epithelial monolayer. Methods: We retrospectively collected the medical records of treatment-naïve exudative age-related macular degeneration patients who were treated with anti-VEGF and observed over 3 years between January 2013 and May 2018. The patient group was divided into type 1 CNV and type 2 CNV groups to investigate changes in visual acuity over 36 months. The effects of age, initial visual acuity, CNV type, and number of injections on final visual acuity were assessed. Results: Among 76 eyes, 46 had type 1 CNV and 30 had type 2 CNV. The best-corrected visual acuity (BCVA) in both groups improved at the 6-month visit and then gradually worsened over the 36-month clinical course. In the type 1 CNV group, there was a statistically significant change in the BCVA over time (p = 0.001). However, there was no significant change in the BCVA over time in the type 2 CNV group (p = 0.163). The type 1 CNV group showed a better BCVA than the type 2 CNV group until the 24-month visit. Age and baseline BCVA, but not CNV type, significantly affected the final BCVA in the multivariate model. Conclusions:The anatomic location of CNV did not influence the final BCVA over long-term continued treatment. The baseline BCVA was a strong predictor of the final BCVA.