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Purpose <p>To evaluate 5-year temporal changes in baseline clinical characteristics—age, axial length, and best-corrected visual acuity—among treatment-naïve eyes with neovascular Age-Related Macular Degenaration (nAMD), comparing pachychoroid neovasculopathy (PNV) with drusen-driven (non-PNV) nAMD at a Japanese tertiary center.</p> Study design <p>Retrospective observational study.</p> Methods <p>Registry data from Kyoto University Hospital were analyzed for patients newly diagnosed with nAMD in 2013/2014 and in 2018/2019. Patients were classified as PNV or non-PNV based on findings derived from multimodal imaging—including optical coherence tomography, indocyanine-green angiography, and color fundus photography. Demographic data, axial length, best-corrected visual acuity (BCVA) at baseline and 1 year posttreatment, and the proportion of eyes achieving ≥0.20 logMAR improvement were compared over time.</p> Results <p>A total of 118 patients were included. In the non-PNV group, mean age rose from 74.35 ± 8.42 years to 77.39 ± 7.90 years (p = 0.021), whereas the PNV group showed a smaller, non-significant change from 68.88 ± 7.25 to 70.41 ± 9.19 years (p = 0.48). Among non-PNV cases, both mean age (p=0.021) and axial length (p=0.017) increased significantly over time. In contrast, PNV cases showed no significant changes in age or axial length. BCVA outcomes and the proportion of patients achieving ≥0.20 logMAR improvement were similar across time points within each subtype. Multivariable logistic regression analysis revealed no significant associations between visual improvement and year, subtype, age, or axial length.</p> Conclusions <p>This study revealed an aging trend and axial elongation among non-PNV cases over time, underscoring a subtype-specific divergence in clinical trajectory.</p>

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Subtype-specific shifts in age, axial length, and clinical profile of neovascular age-related macular degeneration: a five-year study in Japan

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  • 发表日期：

    2025年11月11日

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  • Masahiro Akada,
  • Masayuki Hata,
  • Midori Ideyama,
  • Ai Kido,
  • Manabu Miyata,
  • Hiroshi Tamura,
  • Sotaro Ooto,
  • Akitaka Tsujikawa

摘要

Purpose

To evaluate 5-year temporal changes in baseline clinical characteristics—age, axial length, and best-corrected visual acuity—among treatment-naïve eyes with neovascular Age-Related Macular Degenaration (nAMD), comparing pachychoroid neovasculopathy (PNV) with drusen-driven (non-PNV) nAMD at a Japanese tertiary center.

Study design

Retrospective observational study.

Methods

Registry data from Kyoto University Hospital were analyzed for patients newly diagnosed with nAMD in 2013/2014 and in 2018/2019. Patients were classified as PNV or non-PNV based on findings derived from multimodal imaging—including optical coherence tomography, indocyanine-green angiography, and color fundus photography. Demographic data, axial length, best-corrected visual acuity (BCVA) at baseline and 1 year posttreatment, and the proportion of eyes achieving ≥0.20 logMAR improvement were compared over time.

Results

A total of 118 patients were included. In the non-PNV group, mean age rose from 74.35 ± 8.42 years to 77.39 ± 7.90 years (p = 0.021), whereas the PNV group showed a smaller, non-significant change from 68.88 ± 7.25 to 70.41 ± 9.19 years (p = 0.48). Among non-PNV cases, both mean age (p=0.021) and axial length (p=0.017) increased significantly over time. In contrast, PNV cases showed no significant changes in age or axial length. BCVA outcomes and the proportion of patients achieving ≥0.20 logMAR improvement were similar across time points within each subtype. Multivariable logistic regression analysis revealed no significant associations between visual improvement and year, subtype, age, or axial length.

Conclusions

This study revealed an aging trend and axial elongation among non-PNV cases over time, underscoring a subtype-specific divergence in clinical trajectory.