Real-world Efficacy, Safety, and the Impact of Spherical Equivalent on Intravitreal Anti-VEGF Therapy in Patients Affected by Myopic Choroidal Neovascularisation.

Objective: To analyse real-world clinical outcomes and influence of the spherical equivalent (SE) on anti-vascular endothelial growth factor (VEGF) therapy in patients affected by myopic choroidal neovascularisation (mCNV).

Methods: A retrospective investigation was conducted on treatment-naïve mCNV patients receiving anti-VEGF therapy at the Department of Ophthalmology, University Medical Center Mainz, Germany, between January 2018 and March 2024. Safety, functional and morphological changes in visual acuity (VA), central retinal thickness (CRT), and central retinal volume (CRV) were evaluated over a two-year period. Further, we analysed how baseline VA and CRT relate to it's final outcome measures. Finally, a subgroup analysis assessed the impact of SE above and below - 10 D.

Results: Significant improvements in VA, CRT, and CRV were observed. VA improved from 0.5 ± 0.27 logMAR to 0.38 ± 0.31 logMAR (p = 0.005) at 6 months and remained stable at 2 years. CRT and CRV decreased from 344.4 ± 115.0 µm to 284.2 ± 45.2 µm (p < 0.001) and 0.27 ± 0.09 mm³ to 0.22 ± 0.04 mm³ (p < 0.001), respectively, four weeks after the initial injection, with stability maintained thereafter. Baseline VA correlated strongly with final VA, whereas CRT did not. No adverse events were reported. The subgroup analysis showed no significant outcome differences based on SE.

Conclusions: Anti-VEGF therapy in mCNV patients proved to be safe and effective in our study with sustained improvement in functional and anatomical measures. Baseline VA strongly predicted final VA, whereas baseline and final CRT showed no association. No differences in treatment outcomes were observed as based on a varying SE.