Systemic Oxidative Stress Level as a Pathological and Prognostic Factor in Myopic Choroidal Neovascularization

Abstract

PurposeTo investigate the association of oxidative stress level with myopic choroidal neovascularization (mCNV) and its clinical outcomes. DesignRetrospective case-control study. ParticipantsThis retrospective study included 52 eyes of 52 healthy participants (mean age 62.5 years), 30 eyes of 30 patients (mean age 59.6 years) with high myopia (HM) and no mCNV, and 23 eyes of 23 patients (mean age 61.8 years) with HM and mCNV who received intravitreal anti-vascular endothelial growth factor antibody injections (IVIs) with a pro re nata regimen for 6 months after an initial IVI. MethodsClinical findings, including oxidative stress parameters, such as diacron reactive oxygen metabolites (dROMs), biological antioxidant potential (BAP), and BAP/dROM ratio (B/d ratio), were analyzed. Main Outcome MeasuresClinical features and oxidative stress parameters. ResultsBoth BAP and B/d ratio were significantly lower in the HM/mCNV group than in the HM/no mCNV group (P=0.002 and P=0.012, respectively) or the control group (P=0.001 and P=0.026, respectively). In a multivariate logistic regression analysis (adjusted for age, gender, and axial length), B/d ratio (OR=0.47, P=0.026) was significantly associated with mCNV. Dividing the patients into high and low B/d ratio groups (with a cutoff of 5.2) showed that subfoveal choroidal thickness (SFCT) was lower (P=0.002) and the number of IVI treatments was higher (P=0.029) in eyes with a low B/d ratio than in eyes with a high B/d ratio. In a multiple regression analysis (adjusted for age, gender, and axial length), only B/d ratio was significantly associated with SFCT (β=0.68, P=0.006). ConclusionThe oxidative stress level in eyes with HM differed according to mCNV, SFCT, and the number of IVI treatments. Measuring oxidative stress parameters might be useful in eyes with HM both for assessing the risk of developing mCNV and determining disease activity.