{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:45:04Z","timestamp":1765212304105,"version":"3.46.0"},"reference-count":29,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Different disease subtypes in neovascular age-related macular degeneration (nAMD) influence treatment burden, yet existing classifications such as the pachychoroid neovasculopathy (PNV)\/non-PNV dichotomy may not fully capture clinical heterogeneity. This study aimed to compare the 12-month outcomes of intravitreal aflibercept (IVA) in treatment-na\u00efve patients with unilateral nAMD stratified by the presence or absence of drusen and punctate hyperfluorescence (PH). Methods: This retrospective study included 130 eyes of 130 patients categorized into the Drusen\u2212\/PH\u2212, Drusen+\/PH\u2212, Drusen\u2212\/PH+, and Drusen+\/PH+ groups. Their best-corrected visual acuity, retinal thickness, choroidal thickness, number of injections, no-retinal fluid rate during the loading dose regimen, and 12-month retreatment rate following treatment initiation were determined. The primary outcome was 12-month retreatment rate for the four groups, which was determined using Kaplan\u2013Meier curves and log-rank tests. Exploratory metric multidimensional scaling (MDS) was used to visualize the baseline profiles. Results: The 12-month retreatment rates of the groups were significantly different. The Drusen+\/PH\u2212 group had a higher retreatment rate and required more injections than the Drusen\u2212\/PH+ and Drusen+\/PH+ groups. The Drusen+\/PH\u2212 group was older than the Drusen\u2212\/PH+ and Drusen\u2212\/PH\u2212 groups. The Drusen\u2212\/PH+ group had a thicker choroid than the Drusen+\/PH\u2212 group. The MDS results clear separation of the groups, consistent with the older age of the Drusen+\/PH\u2212 group and the thicker choroid of the Drusen\u2212\/PH+ group. Conclusions: nAMD stratified based on drusen and PH differed in age, choroidal thickness, and IVA outcomes. The four-category framework provides greater pathophysiologic and therapeutic resolution than the simple PNV\/non-PNV dichotomy and may help anticipate injection demand to guide individualized dosing strategies.<\/jats:p>","DOI":"10.3390\/jcm14238593","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:29Z","timestamp":1765210829000},"page":"8593","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics of Patients with Neovascular Age-Related Macular Degeneration and Responses to Anti-VEGF Therapy: Four-Group Stratification Based on Drusen and Punctate Hyperfluorescence"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2194-7063","authenticated-orcid":false,"given":"Hiroyuki","family":"Kamao","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsutoshi","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Mizukawa","sequence":"additional","affiliation":[{"name":"Shirai Eye Hospital, 1339 Takasecho Kamitakase, Mitoyo 767-0001, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryutaro","family":"Hiraki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Miki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuhei","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2805","DOI":"10.1056\/NEJMoa042760","article-title":"Pegaptanib for neovascular age-related macular degeneration","volume":"351","author":"Gragoudas","year":"2004","journal-title":"N. 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