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Purpose <p>We investigated the 7-year incidence rate of macular fibrosis and its related factors in Japanese patients with neovascular age-related macular degeneration (nAMD) receiving anti-vascular endothelial growth factor therapy.</p> Methods <p>This retrospective study involved 301 eyes of 301 treatment-naïve Japanese patients. Macular fibrosis was diagnosed using color fundus photography and spectral-domain optical coherence tomography. We compared clinical parameters between eyes with and without fibrosis. Fibrosis incidence, lesion morphology, and visual outcomes were assessed across nAMD subtypes. A multivariable logistic regression analysis was performed to identify independent factors associated with fibrosis development.</p> Results <p>Fibrosis development was observed in 73 eyes (24.3%). Fibrosis incidence was significantly higher in type 2 macular neovascularization (MNV; 42.1%) than in type 1 MNV (18.1%) and polypoidal choroidal vasculopathy (20.6%). The fibrosis group had significantly worse baseline logarithm of the minimum angle of resolution visual acuity, greater central macular thickness (CMT), and higher incidences of intraretinal fluid (IRF), subretinal hyperreflective material, and retinal hemorrhage than the non-fibrosis group. The most common fibrosis subtype was mixed-type fibrosis, with subretinal fibrosis being more prevalent in type 2 MNV than in type 1 MNV. Visual acuity significantly improved in the non-fibrosis group but not in the fibrosis group. Final visual acuity did not significantly differ across nAMD subtypes in the fibrosis group. In multivariable analysis, worse baseline visual acuity, greater CMT, retinal hemorrhage, IRF, and nAMD subtype were independently associated with fibrosis development.</p> Conclusion <p>Macular fibrosis occurred across all nAMD subtypes and was associated with poor visual outcomes. Worse baseline visual acuity, greater CMT, retinal hemorrhage, IRF, and nAMD subtype were independently associated with fibrosis development. Thus, baseline disease severity and active exudative lesion characteristics may contribute to fibrotic progression in nAMD.</p>

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Long-term analysis of fibrosis in neovascular age-related macular degeneration: A 7-year follow-up

  • 期刊论文

  • 发表日期：

    2026年6月26日

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  • Junichiro Honjo,
  • Ryo Mukai,
  • Kanako Itagaki,
  • Yuka Kato,
  • Yuichiro Tsuchiya,
  • Tadashi Shioya,
  • Keiichiro Tanaka,
  • Koki Norikawa,
  • Yutaka Kato,
  • Akihito Kasai,
  • Tetsuju Sekiryu

摘要

Purpose

We investigated the 7-year incidence rate of macular fibrosis and its related factors in Japanese patients with neovascular age-related macular degeneration (nAMD) receiving anti-vascular endothelial growth factor therapy.

Methods

This retrospective study involved 301 eyes of 301 treatment-naïve Japanese patients. Macular fibrosis was diagnosed using color fundus photography and spectral-domain optical coherence tomography. We compared clinical parameters between eyes with and without fibrosis. Fibrosis incidence, lesion morphology, and visual outcomes were assessed across nAMD subtypes. A multivariable logistic regression analysis was performed to identify independent factors associated with fibrosis development.

Results

Fibrosis development was observed in 73 eyes (24.3%). Fibrosis incidence was significantly higher in type 2 macular neovascularization (MNV; 42.1%) than in type 1 MNV (18.1%) and polypoidal choroidal vasculopathy (20.6%). The fibrosis group had significantly worse baseline logarithm of the minimum angle of resolution visual acuity, greater central macular thickness (CMT), and higher incidences of intraretinal fluid (IRF), subretinal hyperreflective material, and retinal hemorrhage than the non-fibrosis group. The most common fibrosis subtype was mixed-type fibrosis, with subretinal fibrosis being more prevalent in type 2 MNV than in type 1 MNV. Visual acuity significantly improved in the non-fibrosis group but not in the fibrosis group. Final visual acuity did not significantly differ across nAMD subtypes in the fibrosis group. In multivariable analysis, worse baseline visual acuity, greater CMT, retinal hemorrhage, IRF, and nAMD subtype were independently associated with fibrosis development.

Conclusion

Macular fibrosis occurred across all nAMD subtypes and was associated with poor visual outcomes. Worse baseline visual acuity, greater CMT, retinal hemorrhage, IRF, and nAMD subtype were independently associated with fibrosis development. Thus, baseline disease severity and active exudative lesion characteristics may contribute to fibrotic progression in nAMD.