Factors associated with the development of exudation in treatment-naive eyes with nonexudative macular neovascularization

Han Joo Cho; Minchul Kim; Jeongmin Kim; Isang Yoon; Sangmin Park; Chul Gu Kim

doi:10.1007/s00417-024-06384-2

Factors associated with the development of exudation in treatment-naive eyes with nonexudative macular neovascularization

Graefes Arch Clin Exp Ophthalmol. 2024 Feb 13. doi: 10.1007/s00417-024-06384-2. Online ahead of print.

Authors

Han Joo Cho¹, Minchul Kim², Jeongmin Kim², Isang Yoon², Sangmin Park², Chul Gu Kim²

Affiliations

¹ Kim's Eye Hospital, Konyang University College of Medicine, 136, Yeongshin-ro, Yeongdeungpo-gu, Seoul, South Korea. chojoo@kimeye.com.
² Kim's Eye Hospital, Konyang University College of Medicine, 136, Yeongshin-ro, Yeongdeungpo-gu, Seoul, South Korea.

PMID: 38349420
DOI: 10.1007/s00417-024-06384-2

Abstract

Purpose: To identify the predictive factors for development of exudation in patients with treatment-naïve nonexudative macular neovascularization (MNV).

Methods: We retrospectively analyzed 61 treatment-naïve patients with nonexudative MNV who had not received treatment for nonexudative MNV before the exudation developed. Baseline characteristics and changes in MNV were evaluated using multivariate modeling to determine the potential risk factors for exudative conversion.

Results: Exudation development was identified in 31.1% (19/61 eyes) of the study eyes during the 46.2 ± 8.2-month mean follow-up period. The mean period of development of exudation from the baseline was 21.5 ± 6.7 months. Multivariate Cox regression analysis identified that older age (hazard ratio [HR] of 1.380, 95% confidence interval [CI] 1.129-1.688, P = 0.008), larger MNV area at baseline (HR of 1.715, CI 1.288-2.308; P = 0.006), increase of MNV area by doubling (HR of 4.992, CI 1.932-9.246; P = 0.002), and retinal pigment epithelium (RPE) elevation more than 100 μm (HR of 1.017, CI 1.006-1.233; P = 0.015) were associated with increased risk of the development of exudation.

Conclusion: Older age, larger MNV area, increasing MNV area, and higher RPE elevation were associated with an increased risk of exudative conversion in patients with treatment-naïve nonexudative MNV. Identifying these risk factors may be helpful in establishing treatment strategies and monitoring patients.

Keywords: Age-related macular degeneration; Exudation; Macular neovascularization; Optical coherence tomography; Optical coherence tomography angiography; Vascular endothelial growth factor.