Difference in lesion reactivation between pure type 2 and mixed type 1 and 2 macular neovascularization and its influence on long‐term treatment outcomes

Abstract

Aims/Purpose: To compare lesion reactivation and treatment outcomes between pure type 2 and mixed type 1 and 2 macular neovascularization (MNV) treated with anti‐vascular endothelial growth factor (VEGF).Methods: This retrospective study included 155 patients diagnosed with Type 2 MNV. After the initial loading injections, as‐needed retreatment was provided. The difference in first lesion reactivation after the initial treatment was evaluated between pure Type 2 MNV (pure type 2 group, n = 37) and mixed Type 1 and 2 MNV (mixed group, n = 118). The degree of change in the best‐corrected visual acuity (BCVA) was also compared between the two groups.Results: The mean follow‐up period was 32.7 ± 13.7 months. Lesion reactivation differed significantly between the Type 2 (60.0%) and mixed (84.5%) (p = 0.004) groups. The degree of visual change during the follow‐up period also differed significantly between the pure Type 2 (mean 2.8 lines of improvement) and mixed (mean 0.2 lines of deterioration) (p = 0.008) groups. In multivariate analysis, lesion type (p = 0.012) and baseline visual acuity (p = 0.002) were significantly associated with ≥2 lines of visual improvement.Conclusions: Lesion reactivation and treatment outcomes differed between pure Type 2 and mixed Type 1 and 2 MNV. These results suggested the need for different treatment strategies for these two MNV subtypes.