{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:27:43Z","timestamp":1791548863328,"version":"4.3.4"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009053","name":"The Wellcome Trust DBT India Alliance","doi-asserted-by":"publisher","award":["IA\/CRC\/19\/1\/610010]"],"award-info":[{"award-number":["IA\/CRC\/19\/1\/610010]"]}],"id":[{"id":"10.13039\/501100009053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To evaluate incidence, predictors, and re-treatment outcome of recurrent myopic choroidal neovascularization (m-CNV).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Retrospective consecutive observational series. From year 2014 to 2019, 167 eyes of 167 patients of treatment na\u00efve m-CNV were enrolled. 59 and 108 eyes were treated with intra-vitreal ranibizumab and bevacizumab mono-therapy, respectively. Recurrence was defined as re-appearance of CNV activity, confirmed on optical coherence tomography (OCT) after at least 3 months of cessation of anti-VEGF therapy. Incidence of recurrence, predictors and re-treatment outcomes were studied.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Overall, mean age and spherical equivalence (SE) was 47.95 \u00b1 14.72 years and -12.19 \u00b1 4.93 D respectively. Males constituted 50.9%. 44 eyes (26.4%) had a recurrence during a mean follow up of 16.5 \u00b1 12.86 months. Kaplan-Meier survival analysis showed the risk of recurrence was 8, 26 and, 33.6% at 6, 12 and 18 months, respectively. Age (p = 0.511), gender (p = 0.218), SE (p = 0.092), anti-VEGF (p = 0.629) and baseline BCVA (p = 0.519) did not influence recurrence. Number of injections administered to control the disease in the first episode was the only significant predictor of recurrence (Cox Proportional Hazard Ratio 2.89\u20133.07, 95% Confidence Interval: 1.28\u20137.45; p = 0.005). At 12 months, eyes requiring one injection in first episode had a recurrence rate of 12% versus 45% in eyes requiring 3 or more injections in the first episode. A mean number of 1.9 additional injections per eye was needed during re-treatment. Final BCVA in the recurrence group was similar to that of non-recurrence group (0.53 \u00b1 0.40 versus 0.55 \u00b1 0.36 LogMAR; p = 0.755). Baseline BCVA (p = 0.0001) was the only predictor of final visual outcome irrespective of anti-VEGF drug (p = 0.38).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Eyes requiring greater number of injections for disease control in first episode are \u201cat risk\u201d of early m-CNV recurrence. However, recurrence does not adversely affect visual outcome, if treated adequately.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0271342","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T17:59:16Z","timestamp":1658426356000},"page":"e0271342","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Incidence, predictors and re-treatment outcomes of recurrent myopic choroidal neo-vascularization"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4935-2560","authenticated-orcid":true,"given":"Mukesh","family":"Jain","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja","family":"Narayanan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Jana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5520-4930","authenticated-orcid":true,"given":"Ashik","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Raman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavan","family":"Verkicharla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikanta Kumar","family":"Padhy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9692-2621","authenticated-orcid":true,"given":"Anthony Vipin","family":"Das","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Chhablani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,7,21]]},"reference":[{"key":"pone.0271342.ref001","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.preteyeres.2017.09.004","article-title":"The epidemics of myopia: Aetiology and prevention","volume":"62","author":"IG Morgan","year":"2018","journal-title":"Prog Retin Eye Res"},{"issue":"5","key":"pone.0271342.ref002","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1136\/bjophthalmol-2018-313308","article-title":"Prevalence and causes of vision loss in East Asia in 2015: magnitude, temporal trends and projections","volume":"104","author":"CY Cheng","year":"2020","journal-title":"Br J Ophthalmol"},{"key":"pone.0271342.ref003","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ajo.2013.08.010","article-title":"Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review","volume":"157","author":"TY Wong","year":"2014","journal-title":"Am J Ophthalmol"},{"issue":"1","key":"pone.0271342.ref004","doi-asserted-by":"crossref","first-page":"13700","DOI":"10.1038\/s41598-018-29536-x","article-title":"Patterns of posterior ocular complications in myopic eyes of Indian population","volume":"8","author":"R Dhakal","year":"2018","journal-title":"Sci Rep."},{"issue":"12","key":"pone.0271342.ref005","doi-asserted-by":"crossref","first-page":"7532","DOI":"10.1167\/iovs.13-12795","article-title":"The economic cost of myopia in adults aged over 40 years in Singapore","volume":"54","author":"YF Zheng","year":"2013","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"12","key":"pone.0271342.ref006","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1016\/S0161-6420(84)34116-1","article-title":"Natural history of choroidal neovascularization in degenerative myopia","volume":"91","author":"MP Avila","year":"1984","journal-title":"Ophthalmology"},{"key":"pone.0271342.ref007","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.survophthal.2014.10.002","article-title":"The other CNVM: a review of myopic choroidal neovascularization treatment in the age of anti-vascular endothelial growth factor agents","volume":"60","author":"FA Adatia","year":"2015","journal-title":"Surv Ophthalmol"},{"key":"pone.0271342.ref008","doi-asserted-by":"crossref","first-page":"733","DOI":"10.2147\/OPTH.S49437","article-title":"Current and emerging treatment options for myopic choroidal neovascularization","volume":"9","author":"L El Matri","year":"2015","journal-title":"Clin Ophthalmol."},{"key":"pone.0271342.ref009","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1136\/bjophthalmol-2014-305131","article-title":"Myopic choroidal neovascularisation: current concepts and update on clinical management","volume":"99","author":"TY Wong","year":"2015","journal-title":"Br J Ophthalmol"},{"key":"pone.0271342.ref010","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1097\/IAE.0b013e3181b1bb1a","article-title":"Anti-VEGF drugs as the 2009 first-line therapy for choroidal neovascularization in pathologic myopia","volume":"29","author":"SY Cohen","year":"2009","journal-title":"Retina"},{"key":"pone.0271342.ref011","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s00417-011-1889-0","article-title":"Recent trends in the management of maculopathy secondary to pathological myopia","volume":"250","author":"D Mitry","year":"2012","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"pone.0271342.ref012","doi-asserted-by":"crossref","first-page":"3413","DOI":"10.2147\/DDDT.S87920","article-title":"Anti-VEGF treatment for myopic choroid neovascularization: from molecular characterization to update on clinical application","volume":"9","author":"Y Zhang","year":"2015","journal-title":"Drug Des Devel Ther."},{"key":"pone.0271342.ref013","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1097\/IAE.0b013e31827d260a","article-title":"Intravitreal anti-vascular endothelial growth factor for choroidal neovascularization secondary to pathologic myopia: systematic review and meta-analysis","volume":"33","author":"E Wang","year":"2013","journal-title":"Retina"},{"issue":"1","key":"pone.0271342.ref014","doi-asserted-by":"crossref","first-page":"e0227557","DOI":"10.1371\/journal.pone.0227557","article-title":"Real-world effectiveness and safety of ranibizumab for the treatment of myopic choroidal neovascularization: Results from the LUMINOUS study","volume":"15","author":"RD Hamilton","year":"2020","journal-title":"PLoS One"},{"issue":"3","key":"pone.0271342.ref015","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.ophtha.2013.10.023","article-title":"RADIANCE: a randomized controlled study of ranibizumab in patients with choroidal neovascularization secondary to pathologic myopia","volume":"121","author":"S Wolf","year":"2014","journal-title":"Ophthalmology"},{"issue":"6","key":"pone.0271342.ref016","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1016\/j.ophtha.2015.01.025","article-title":"Intravitreal Aflibercept Injection in Patients with Myopic Choroidal Neovascularization: The MYRROR Study","volume":"122","author":"Y Ikuno","year":"2015","journal-title":"Ophthalmology"},{"issue":"2","key":"pone.0271342.ref017","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1136\/bjo.2008.145797","article-title":"Intravitreal bevacizumab (Avastin) for myopic choroidal neovascularisation: 1-year results of a prospective pilot study","volume":"93","author":"WM Chan","year":"2009","journal-title":"Br J Ophthalmol"},{"issue":"11","key":"pone.0271342.ref018","first-page":"2042","article-title":"Intravitreal injection of bevacizumab for myopic choroidal neovascularization: 1-year follow-up","volume":"23","author":"PC Wu","year":"2009","journal-title":"EyeNov"},{"issue":"2","key":"pone.0271342.ref019","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1136\/bjo.2006.096776","article-title":"Intravitreal bevacizumab (Avastin) as treatment for subfoveal choroidal neovascularisation secondary to pathological myopia","volume":"91","author":"I Yamamoto","year":"2007","journal-title":"Br J Ophthalmol"},{"issue":"12","key":"pone.0271342.ref020","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1016\/j.ophtha.2007.03.043","article-title":"Intravitreal bevacizumab (Avastin) for myopic choroidal neovascularization: six-month results of a prospective pilot study","volume":"114","author":"WM Chan","year":"2007","journal-title":"Ophthalmology"},{"issue":"1","key":"pone.0271342.ref021","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.ajo.2008.07.022","article-title":"Intravitreal bevacizumab treatment for choroidal neovascularization in pathologic myopia: 12-month results","volume":"147","author":"M Gharbiya","year":"2009","journal-title":"Am J Ophthalmology"},{"key":"pone.0271342.ref022","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.ajo.2009.10.010","article-title":"Choroidal neovascularization in pathologic myopia: intravitreal ranibizumab versus bevacizumab-a randomized controlled trial","volume":"149","author":"M Gharbiya","year":"2010","journal-title":"Am J Ophthalmol"},{"key":"pone.0271342.ref023","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1097\/IAE.0b013e31826956b7","article-title":"Intravitreal ranibizumab versus bevacizumab for treatment of myopic choroidal neovascularization","volume":"32","author":"P Iacono","year":"2012","journal-title":"Retina"},{"key":"pone.0271342.ref024","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1007\/s00417-014-2886-x","article-title":"A randomized trial of intravitreal bevacizumab vs. ranibizumab for myopic CNV","volume":"253","author":"A Pece","year":"2015","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"pone.0271342.ref025","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1471-2415-14-69","article-title":"Comparison of 1-year therapeutic effect of ranibizumab and bevacizumab for myopic choroidal neovascularization: a retrospective, multicenter, comparative study","volume":"14","author":"DM Cha","year":"2014","journal-title":"BMC Ophthalmol."},{"issue":"7","key":"pone.0271342.ref026","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1038\/eye.2012.97","article-title":"Long-term outcome of intravitreal anti-vascular endothelial growth factor therapy with bevacizumab or ranibizumab as primary treatment for subfoveal myopic choroidal neovascularization","volume":"26","author":"TY Lai","year":"2012","journal-title":"Eye"},{"issue":"10","key":"pone.0271342.ref027","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1136\/bjophthalmol-2015-307802","article-title":"Comparison of photodynamic therapy, ranibizumab\/bevacizumab or combination in the treatment of myopic choroidal neovascularisation: a 9-year-study from a single centre","volume":"100","author":"P Rishi","year":"2016","journal-title":"Br J Ophthalmol"},{"issue":"13","key":"pone.0271342.ref028","first-page":"4951","article-title":"Factors associated with recurrent choroidal neovascularization due to pathological myopia treated with intravitreal anti-vascular endothelial growth factor injections","volume":"55","author":"Y Jo","year":"2014","journal-title":"Investigative Ophthalmology & Visual Science"},{"issue":"8","key":"pone.0271342.ref029","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1097\/IAE.0b013e318285cc24","article-title":"Ocular risk factors for recurrence of myopic choroidal neovascularization: long-term follow-up study","volume":"33","author":"HM Kang","year":"2013","journal-title":"Retina"},{"issue":"6","key":"pone.0271342.ref030","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/j.ajo.2013.08.002","article-title":"Prognostic factors of eyes with naive subfoveal myopic choroidal neovascularization after intravitreal bevacizumab","volume":"156","author":"HS Yang","year":"2013","journal-title":"Am J Ophthalmol"},{"issue":"11","key":"pone.0271342.ref031","doi-asserted-by":"crossref","first-page":"2228","DOI":"10.1097\/IAE.0000000000001858","article-title":"Long-term outcomes of ranibizumab treatment of myopic choroidal neovascularization in East-Asian patients from the radiance study","volume":"38","author":"NW Tan","year":"2017","journal-title":"Retina"},{"issue":"12","key":"pone.0271342.ref032","doi-asserted-by":"crossref","first-page":"2457","DOI":"10.1097\/IAE.0000000000000610","article-title":"Factors influencing need for retreatment and long-term visual outcome after intravitreal bevacizumab for myopic choroidal neovascularization","volume":"35","author":"DS Ng","year":"2015","journal-title":"Retina"},{"issue":"3","key":"pone.0271342.ref033","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1159\/000458160","article-title":"Improved visual outcome and low recurrence with early treatment with intravitreal anti-vascular endothelial growth factor in myopic choroidal neovascularization","volume":"237","author":"BG Moon","year":"2017","journal-title":"Ophthalmologica"},{"issue":"5","key":"pone.0271342.ref034","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1136\/bjo.87.5.570","article-title":"Patchy atrophy and lacquer cracks predispose to the development of choroidal neovascularisation in pathological myopia","volume":"87","author":"K Ohno-Matsui","year":"2003","journal-title":"Br J Ophthalmol"},{"issue":"11","key":"pone.0271342.ref035","doi-asserted-by":"crossref","first-page":"2228","DOI":"10.1097\/IAE.0000000000001858","article-title":"Long-term outcomes of ranibizumab treatment of myopic choroidal neovascularization in East-Asian patients from the radiance study","volume":"38","author":"NW Tan","year":"2018","journal-title":"Retina (Philadelphia, Pa.)"},{"key":"pone.0271342.ref036","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1136\/bjophthalmol-2012-302973","article-title":"Intravitreal anti-VEGF therapy for choroidal neovascularisation secondary to pathological myopia: 4-year outcome","volume":"97","author":"JM Ruiz-Moreno","year":"2013","journal-title":"Br J Ophthalmol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0271342","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T18:00:00Z","timestamp":1658426400000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0271342"}},"subtitle":[],"editor":[{"given":"Ramesh","family":"Venkatesh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,7,21]]},"references-count":36,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0271342","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,21]]}}}