Comparison of Choroidal Vascularity Index Between Type 1 and Type 2 Macular Neovascularization Before and After Anti-VEGF Therapy

Purpose To compare choroidal structural features and visual and anatomical outcomes between type 1 and type 2 macular neovascularization (MNV) at baseline and following anti-vascular endothelial growth factor (anti-VEGF) therapy.Methods This retrospective study included 56 eyes of 44 patients with treatment-naïve neovascular age-related macular degeneration treated with intravitreal anti-VEGF. Choroidal vascularity index (CVI), best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (CST), and macular fluid status were assessed at baseline and the final follow-up visit.Results At baseline, CMT was significantly lower in type 1 than in type 2 MNV (p 0.047), whereas CVI did not differ significantly between groups (p 0.091). At the final visit, CVI also showed no significant difference between subtypes. BCVA improved and CMT decreased descriptively in both groups, whereas CST decreased and CVI remained essentially stable. After adjustment for baseline values and actual follow-up duration, no significant differences were found between subtypes in final BCVA, CMT, CST, CVI, or macular fluid status (all p > .05).Conclusion No significant differences in CVI were found between type 1 and type 2 MNV at baseline or final follow-up, and longitudinal changes were comparable between subtypes. These findings do not support a predominant role of choroidal vascularity in distinguishing MNV subtypes. As retinal pigment epithelium integrity was not assessed, its potential contribution remains unclear. Larger prospective studies with standardized treatment protocols are needed to clarify the mechanisms underlying different MNV growth patterns.