Recurrence timing and visual outcomes of recurrent myopic choroidal neovascularization after anti-VEGF therapy

Int J Retina Vitreous. 2026 Jul 11. doi: 10.1186/s40942-026-00900-8. Online ahead of print.

Abstract

Purpose: To compare clinical characteristics and visual outcomes according to recurrence timing in eyes with myopic choroidal neovascularization (CNV) following anti-vascular endothelial growth factor (anti-VEGF) therapy.

Methods: This retrospective cohort study included eyes with treatment-naïve myopic CNV that achieved complete resolution after initial anti-VEGF therapy. To specifically evaluate the impact of recurrence timing, analyses were restricted to eyes that developed recurrence, which were categorized as early (< 12 months) or late (≥ 12 months). Baseline characteristics, multimodal imaging features, treatment profiles, and recurrence-specific parameters were compared. Longitudinal changes in best-corrected visual acuity (BCVA) were analyzed using linear mixed-effects models, and factors associated with the final BCVA were evaluated using multivariable linear regression.

Results: Of the 79 eyes, 32 (40.5%) experienced recurrence during the mean follow-up of 36.9 ± 23.7 months (early: 15 eyes; late: 17 eyes). The early recurrence group exhibited a significantly longer axial length (p = 0.019); other baseline features and treatment profiles were similar between groups. At recurrence, subretinal hyperreflective material height was significantly greater in the late recurrence group (p = 0.041). Both groups showed visual improvement after initial treatment, without a significant difference in BCVA at any predefined time point. Baseline BCVA was the only independent predictor for final BCVA (β = 0.46, p = 0.039); no significant association between recurrence timing and visual outcomes was detected.

Conclusion: Visual outcomes were comparable between early and late recurrences of myopic CNV. Baseline BCVA was the strongest factor associated with long-term visual outcome, whereas no association between recurrence timing and visual outcomes was detected in this cohort.

Keywords: Choroidal neovascularization; Myopia; Optical coherence tomography; Recurrence; Visual acuity.