Authors:Wang Qian, Wang Haiyan, Zhang Lei, Ren Yuecong, Yan Hong
Corresponding author:Yan Hong, Email:yan2128ts@hotmail.com
Published:2026-07-10
DOI:10.3760/cma.j.cn115989-20250120-00017
ABSTRACT
Objective Based on the new classification of macular neovascularization (MNV), to observe the treatment characteristics of anti-vascular endothelial growth factor (VEGF) in patients with neovascular age-related macular degeneration (nAMD) complicated with cataracts after phacoemulsification.
Methods A retrospective cohort study was conducted. Forty-nine nAMD patients (49 eyes) combined with cataracts who underwent cataract surgery at Xi’an People’s Hospital from March 2022 to August 2024 were enrolled. All patients underwent visual acuity, spectral-domain optical coherence tomography (OCT), and OCT angiography examinations. Patients were divided into an intraoperative non-injection group and an intraoperative injection group based on whether they received the administration of combined anti-VEGF treatment during the surgery or not. Based on the new MNV classification, patients were classified into types Ⅰ, Ⅱ, and Ⅲ. The frequency of postoperative anti-VEGF treatments, best corrected visual acuity (BCVA), and MNV height were recorded to analyze the factors influencing postoperative BCVA and MNV height and compare the differences in MNV height before and after surgery between the intraoperative non-injection and injection groups for different MNV types. This study adhered to the Declaration of Helsinki, and the research protocol was approved by the Clinical Ethics Committee of Xi’an People’s Hospital (No. 20210087). All patients and their families signed informed consent forms.
Results The frequencies of anti-VEGF treatment for type Ⅰ, Ⅱ, and Ⅲ MNV patients were (2.57±1.54), (2.25±1.02), and (2.75±1.83) times, respectively, with no significant overall difference ( F=0.384, P=0.683). Using type Ⅲ MNV as a reference, linear generalized estimating equation analysis showed that the treatment frequency for types Ⅰ and Ⅱ MNV was a factor influencing postoperative BCVA and MNV height. As treatment frequency increased, BCVA improved, and MNV height decreased, with type Ⅰ MNV demonstrating more pronounced improvement. The MNV height in the intraoperative injection group one month after surgery was (216.81±179.71)μm, respectively, which were significantly lower than the preoperative (285.29±210.54)μm ( t=4.356, P<0.001). For patients with type Ⅱ MNV, the difference in MNV height was greater in the intraoperative injection group than in the intraoperative non-injection group, and the difference was statistically significant ( t=2.579, P=0.023).
Conclusions There is no significant difference in the frequency of postoperative anti-VEGF treatment among nAMD patients with different MNV types complicated with cataracts. The MNV type is associated with BCVA and the change in MNV height. Among them, as the number of treatments increases, the BCVA and MNV height of type Ⅰ MNV patients improve more significantly. The combined intraoperative anti-VEGF treatment has a greater impact on the height change of type Ⅱ MNV.
KEYWORDS：
Macular neovascularization;Neovascular age-related macular degeneration;Cataract;Vascular endothelial growth factor
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Authors Info & Affiliations
Wang Qian
Department of Ophthalmology, The First Hospital of Yulin, Yulin 719000, China
Wang Qian is a visiting physician at Xi’an People’s Hospital
Wang Haiyan
Shaanxi Eye Hospital, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an Key Laboratory of Digital Medical Technology of Ophthalmologic Imaging, Xi’an 710004, China
Zhang Lei
Shaanxi Eye Hospital, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an Key Laboratory of Digital Medical Technology of Ophthalmologic Imaging, Xi’an 710004, China
Ren Yuecong
Shaanxi Eye Hospital, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an Key Laboratory of Digital Medical Technology of Ophthalmologic Imaging, Xi’an 710004, China
Yan Hong
Shaanxi Eye Hospital, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an Key Laboratory of Digital Medical Technology of Ophthalmologic Imaging, Xi’an 710004, China
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