Aims To explore prognostic multimarker models for progression to macular fibrosis (MF) over 24 months specific to type 3 macular neovascularisation (T3 MNV). Methods This retrospective, exploratory, single-centre, cohort study comprised 65 eyes of 43 Caucasian patients with treatment naive T3 MNV, all with a 24-month follow-up post anti-VEGF therapy using a strict pro-re-nata (PRN) regimen. Data on demographic features, clinical findings, frequency of intravitreal treatments and optical coherence tomography biomarkers were collected at baseline and after 12 and 24 months of follow-up. Logistic regression models (LRM) and receiver-operating curve (C-index) analyses were performed to evaluate the prognostic ability of the studied biomarkers in discriminating between MF affected and unaffected patients. Results At final follow-up, MF was present in 46.2% of eyes. Subretinal hyper-reflective material (SHRM) and subretinal pigment epithelium multilaminar hyper-reflectivity (multilaminae) emerged as significant predictors for MF, with adjusted odds ratios (OR) of 18.0 (95% CL 13.4 to 24.1) and 11.8 (95% CL 8.66 to 16.0), respectively. Additionally, the presence of multifocal lesions (OR 0.04, 95% CL 0.01 to 0.30) appeared to decrease the likelihood of MF. C-indexes for the selected LRMs ranged between 0.92 and 0.88, indicating a comparably high discriminant ability. Despite consistent treatment schedules between the two groups (MF: median intravitreal treatment (IVT) number=10.5, IQR=7; non-MF: median IVT=10, IQR=6), a decline in best-corrected visual acuity was noted in the group with MF onset over the 24-month follow-up (−13.0 ETDRS letters; 95% CL –22.1 to –3.9; p=0.006). Conclusion Our study identifies SHRM and multilaminae as relevant predictors of 24-month onset of MF in patients with T3 MNV. These findings enrich our understanding of the development of MF in T3 MNV and can guide improved risk prognostication. Future research should consider larger samples and prospective designs to validate these predictors. Data are available on reasonable request.

中文翻译：

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3 型黄斑新生血管中黄斑纤维化 24 个月发病的预测因素


目的 探索 24 个月内进展为黄斑纤维化 (MF) 的预后多标志物模型，具体针对 3 型黄斑新生血管 (T3 MNV)。方法 这项回顾性、探索性、单中心队列研究包括 43 名患有初治 T3 MNV 的白种人患者的 65 只眼睛，所有患者均在抗 VEGF 治疗后使用严格的 pro-re-nata (PRN) 进行了 24 个月的随访养生法。在基线以及 12 个月和 24 个月的随访后收集人口特征、临床结果、玻璃体内治疗频率和光学相干断层扫描生物标志物的数据。进行逻辑回归模型 (LRM) 和受试者工作曲线 (C 指数) 分析，以评估所研究的生物标志物区分 MF 受影响和未受影响患者的预后能力。结果 在最终随访时，46.2% 的眼睛存在 MF。视网膜下高反射材料 (SHRM) 和视网膜下色素上皮多层高反射率 (multilaminae) 成为 MF 的重要预测因素，调整后的比值比 (OR) 为 18.0（95% CL 13.4 至 24.1）和 11.8（95% CL 8.66）至 16.0）。此外，多灶性病变的存在（OR 0.04，95% CL 0.01 至 0.30）似乎会降低 MF 的可能性。所选 LRM 的 C 指数范围在 0.92 至 0.88 之间，表明具有较高的判别能力。尽管两组之间的治疗方案一致（MF：玻璃体内治疗（IVT）中位数=10.5，IQR=7；非MF：中位IVT=10，IQR=6），但最佳矫正视力下降24 个月随访期间出现 MF 的组（−13.0 ETDRS 字母；95% CL –22.1 至 –3.9；p=0.006）。 结论 我们的研究确定 SHRM 和多层板是 T3 MNV 患者 24 个月 MF 发病的相关预测因素。这些发现丰富了我们对 T3 MNV 中 MF 发展的理解，并可以指导改进的风险预测。未来的研究应该考虑更大的样本和前瞻性设计来验证这些预测因素。可根据合理要求提供数据。