Vitreoretinal Interface Changes After Anti-vascular Endothelial Growth Factor Treatment in Highly Myopic Eyes: A Real-World Study

Mei-Chi Tsui; Yi-Ting Hsieh; Tso-Ting Lai; Yun Hsia; Shih-Wen Wang; I-Hsin Ma; Kuo-Chi Hung; Chang-Pin Lin; Chang-Hao Yang; Chung-May Yang; Tzyy-Chang Ho

doi:10.1007/s40123-023-00701-4

Vitreoretinal Interface Changes After Anti-vascular Endothelial Growth Factor Treatment in Highly Myopic Eyes: A Real-World Study

Ophthalmol Ther. 2023 Jun;12(3):1693-1710. doi: 10.1007/s40123-023-00701-4. Epub 2023 Apr 1.

Authors

Mei-Chi Tsui^{1

2}, Yi-Ting Hsieh^{1

3}, Tso-Ting Lai^{1

3}, Yun Hsia^{1

4}, Shih-Wen Wang^{1

5}, I-Hsin Ma^{1

4}, Kuo-Chi Hung^{1

6}, Chang-Pin Lin^{1

3}, Chang-Hao Yang^{1

3}, Chung-May Yang^{1

3}, Tzyy-Chang Ho^{7

8}

Affiliations

¹ Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan.
² Department of Ophthalmology, An Nan Hospital, China Medical University, Tainan, Taiwan.
³ Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁴ Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
⁵ Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
⁶ Universal Eye Clinic, Taipei, Taiwan.
⁷ Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei, 10002, Taiwan. [email protected].
⁸ Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan. [email protected].

Abstract

Introduction: To investigate changes in the vitreoretinal interface after anti-vascular endothelial growth factor (anti-VEGF) treatment in highly myopic eyes.

Methods: Eyes with myopic choroidal neovascularization (mCNV) treated with intravitreal injection of anti-VEGF in a single-center were retrospectively reviewed. Fundus abnormalities and features of optical computed tomography were studied.

Results: A total of 295 eyes from 254 patients were recruited to the study. Prevalence of myopic macular retinoschisis (MRS) was 25.4%, and the rates of progression and onset of MRS were 75.9% and 16.2%, respectively. Outer retinal schisis (β = 8.586, p = 0.003) and lamellar macular hole (LMH) (β = 5.015, p = 0.043) at baseline were identified risk factors for progression and onset of MRS, whereas male sex (β = 9.000, p = 0.039) and outer retinal schisis at baseline (β = 5.250, p = 0.010) were risk factors for MRS progression. Progression of MRS was first detected in outer retinal layers in 48.3% of eyes. Thirteen eyes required surgical intervention. Spontaneous improvements of MRS were observed in five eyes (6.3%).

Conclusion: Changes in the vitreoretinal interface, such as progression, onset, and improvement of MRS, were observed after anti-VEGF treatment. Outer retinal schisis and LMH were risk factors of progression and onset of MRS after anti-VEGF treatment. Intravitreal injection of ranibizumab and retinal hemorrhage were protective factors for surgical intervention for vision-threatening MRS.

Keywords: Anti-vascular endothelial growth factor; High myopia; Myopic choroidal neovascularization; Myopic macular retinoschisis; Myopic traction maculopathy; Vitreoretinal interface.