Purpose: This study investigated factors associated with chorioretinal atrophy (CRA) progression in myopic choroidal neovascularization (CNV) after anti-vascular endothelial growth factor therapy. Methods: Fifty eyes of 50 treatment-naive patients with myopic CNV who underwent anti-vascular endothelial growth factor monotherapy with at least 2 years of follow-up data were included. The cumulative occurrence of CRA progression was assessed using a Kaplan-Meier analysis. Demographic and clinical characteristics including macular choroidal thickness in various areas were compared between patients with and without CRA progression. Results: The mean age was 52.34 years. A mean of 4.84 anti-vascular endothelial growth factor injections were performed over the mean follow-up duration of 44.6 months. Eventually, 15 eyes (30%) developed CRA progression. The estimated occurrence of CRA progression was 10% at 1 year, 19.1% at 2 years, 23.6% at 3 and 4 years, and 35.4% at 5 years. Chorioretinal atrophy progression was associated with a subfoveal CNV location (P = 0.029) and thinner subfoveal choroid in relation to the inferior choroid at 3 mm (P = 0.008). Visual improvement was only significant in eyes without CRA progression at 1 year, 2 years, and at the final visit. Conclusion: Chorioretinal atrophy progression was associated with a poor long-term prognosis. Relative thinning of the subfoveal choroid about the inferior choroid and subfoveal CNV location may predispose eyes with myopic CNV to develop CRA progression after anti-vascular endothelial growth factor therapy.
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