Abstract
Purpose. To determine the effect of increased axial length of the eyes on the course of choroidal neovascularization (CNV) in patients with neovascular age-related macular degeneration (AMD) during anti-VEGF therapy. Material and methods. The study included 29 people (34 eyes) with neovascular AMD occurring against the background of axial myopia, in comparison with control eyes. The length of the anterior-posterior axis (APA) was 25.42 (24.25; 27.55) mm. The influence of axial myopia on degenerative changes in the fundus such as myopic maculopathy and posterior staphyloma (PS) was analyzed. The type of CNV, parameters of the neovascular complex and retina, retinal microcirculation in the foveal area before treatment and at the end of the observation period, and correlations were assessed using optical coherence tomography (OCT) and OCT angiography (OCTA). Treatment was with intravitreal anti-VEGF. The follow-up period was 28.80 (15.18; 44.10) months. The number of intravitreal injections (IVI) was 7.75 (5.70; 9.85). Results. «Mild» categories of myopic maculopathy were detected by ophthalmoscopy – mosaic fundus (K1) in 20.60% and diffuse chorioretinal atrophy (K2) in 17.60% of cases. PS in eyes with CNV and fellow eyes was detected in 17.50 and 21.00% of eyes, respectively, types were identified exclusively without involvement of the macular area. CNV types 1 and 2 were detected in equal proportions – in 43.48 and 56.52% of eyes, respectively. Visual functions and OCT parameters of the retina and CNV reached the maximum positive values after 2 loading injections of anti-VEGF. A significant positive dynamics of retinal microcirculation in the foveal zone was established by the end of the observation period against the background of a decrease in exudative changes in the retina. Correlation analysis showed a direct relationship between the number of injections and the extent of CNV before treatment (rφ=0.743; p=0.009) and the height of the neuroepithelium above the CNV before treatment (r φ=0.378; p=0.027). Conclusion. The presence of axial myopia in patients with neovascular AMD contributes to the appearance of minimal degenerative changes in the posterior pole of the eyes, which has a positive effect on visual function and CNV during antiVEGF therapy. Key words: choroidal neovascularization, neovascular age-related macular degeneration, axial myopia, optical coherence tomography angiography, anti-VEGF therapy
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