Long-term results of intravitreal bevacizumab for choroidal neovascularisation in pathological myopia

Gharbiya, Magda; Cruciani, F; Parisi, Francesco; Cuozzo, G; Altimari, Simona; Abdolrahimzadeh, Solmaz

doi:10.1136/bjophthalmol-2012-301639

Cited by 42 publications

(34 citation statements)

References 23 publications

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“…Franqueira et al [25] reported a lower improvement in BCVA of +4.3, +6.4 and +8 letters after 1, 2 and 3 years of treatment with IVR, respectively. The initial VA explains much of this difference in magnitude of the results, since eyes with an inferior initial VA have the opportunity for greater improvement with treatment [24]. Our results showed that among the pretreatment factors analysed, baseline BCVA was the main variable influencing the BCVA 2 and 3 years after treatment.…”

Section: Discussionmentioning

confidence: 58%

“…These results are in accordance with those of other reports concerning ranibizumab [14,15,17,25,29,30] and bevacizumab [11,12,13,16] with shorter follow-up periods. Although most of these studies have used the logMAR scale for the assessment of BCVA, two distinct studies, using the ETDRS scale, reported a gain of 18.2 letters at 1 year [13] and 16.5 letters at 2 and 3 years [24] of treatment with IVB. Franqueira et al [25] reported a lower improvement in BCVA of +4.3, +6.4 and +8 letters after 1, 2 and 3 years of treatment with IVR, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…In another prospective study, Silva et al [14] reported a significant gain of 8 letters in eyes treated with IVR. The overall sustainability of these results up to 2 years of follow-up has been documented with dichotomous outcomes; some studies revealed a loss of BCVA [18,19,20], whilst others demonstrated a maintenance of VA until 2 [21,22,23,24] and 3 years of follow-up [24] in eyes treated with IVB. Franqueira et al [25] also showed that treatment with IVR is a successful therapeutic option, improving VA for up to 3 years.…”

Section: Introductionmentioning

confidence: 99%

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Anti-VEGF Therapy in Myopic Choroidal Neovascularization: Long-Term Results

Freitas-da-Costa

Pinheiro-Costa²,

Carvalho³

et al. 2014

Ophthalmologica

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Purpose: To evaluate the medium- and long-term efficacy of anti-VEGF agents in the treatment of choroidal neovascularization secondary to pathologic myopia (mCNV). Methods: We performed a retrospective analysis of patients with mCNV who had been treated with intravitreous anti-VEGF for at least 2 years. The best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were compared before and after the treatment. The number of injections per year was also assessed. Results: The results were analysed at 2 years for 67 eyes, at 3 years for 52 eyes, at 4 years for 28 eyes and at 5 years for 13 eyes. The mean change from baseline BCVA was significant at 2 years (+8.6 letters; p < 0.001) and this gain remained significantly stable for a period of 5 years. The mean CRT showed a significant decrease over time, with a nadir at 2 years (-104.0 μm; p < 0.001). The mean number of injections performed during the first year was 5.2, being lower in subsequent years (p < 0.001). Conclusion: In this subset of patients with mCNV, an intravitreous therapy with anti-VEGF agents proved to have effective results over 5 years, with a sustained increase in BCVA.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anti-VEGF Therapy in Myopic Choroidal Neovascularization: Long-Term Results

Freitas-da-Costa

Pinheiro-Costa²,

Carvalho³

et al. 2014

Ophthalmologica

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“…6,[8][9][10][11][12] The mean final VA in patients treated with anti-VEGF drugs reported in the literature ranges from 0.23 to 0.55 (Table 2). [6][7][8][9][10][11][12][31][32][33][34][35][36] More importantly, in studies which have compared anti-VEGF with PDT treatment for myopic CNV, patients treated with anti-VEGF generally achieved better visual outcomes compared with the group treated with PDT. 7,24,25 It is important to note, however, that in these studies, patients…”

Section: Discussionmentioning

confidence: 99%

Comparison of foveal-sparing with foveal-involving photodynamic therapy for myopic choroidal neovascularization

Tan

Chew

2013

Eye

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Purpose To evaluate the visual outcomes of choroidal neovascularization (CNV) secondary to pathological myopia in eyes treated with photodynamic therapy (PDT), and to determine the effect of lesion location and foveal involvement on visual prognosis. Methods Interventional case series of 24 consecutive patients with myopic CNV treated with PDT. The main outcome measure was final LogMAR visual acuity (VA). Results Of 24 eyes, the CNV lesion was subfoveal in 11 and extrafoveal in 13. Overall, the mean LogMAR VA at 24 months was 0.72. Extrafoveal CNV lesions achieved significantly better final VA compared with subfoveal CNV (LogMAR 0.45 vs 1.05, P ¼ 0.012). Eyes with extrafoveal CNV lesions were subdivided into foveal-sparing PDT (where the PDT laser spot did not involve the foveal center) and foveal-involved PDT (where the PDT laser covered the fovea). At all time points, the group with fovealsparing PDT had significantly better VA compared with the foveal-involved group. The final LogMAR VA for the foveal-sparing PDT group was 0.26 compared with 1.00 for the foveal-involved PDT group (P ¼ 0.003). At 24 months, 77.8% of foveal-sparing PDT cases achieved VA of Z20/40, compared with 25% of foveal-involved PDT cases and 9.1% of subfoveal CNV lesions (P ¼ 0.006). Conclusion For patients with myopic CNV, foveal-sparing PDT results in significantly better long-term visual outcomes compared with those with foveal-involved PDT. Fovealsparing PDT may be of value for treatment of myopic CNV patients who are not suitable for treatment with anti-vascular endothelial growth factor injections.

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“…[2][3][4]11,26 O ranibizumab e o bevacizumab são anticorpos monoclonais antiangiogénicos utilizados no tratamento da neovascularização coroideia, com resultados favoráveis a curto prazo. 9,27 Estudos recentes demonstraram resultados benéficos e sustentados da terapêutica com bevacizumab na NVC miópica, 28,29 estando em curso ensaios clínicos randomizados e multicêntricos para avaliar a eficácia do ranibizumab a longo prazo.…”

Section: Introductionunclassified

Avaliação dos Resultados do Tratamento Antiangiogénico na Neovascularização Coroideia Associada à Miopia Patológica

et al. 2014

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Introduction: Choroidal neovascularization secondary to pathological myopia is one of the leading causes of irreversible central vision loss in younger patients. The purposes of our study is to evaluate the long-term results of antiangiogenic treatment, with ranibizumab and/or bevacizumab, in myopic choroidal neovascularization and define the predictive factors for visual and anatomic outcomes. Material and Methods:In this study were included 84 eyes from 81 patients with myopic choroidal neovascularization. Eighty-four (100%) eyes accomplish 12 months of follow-up, 67 (79.8%) 24 months, 54 (64.3%) 36 months, 29 (34.5%) 48 months, and 15 (16.7%) 60 months. We retrieved data related to best corrected visual acuity measured with ETDRS chart, foveal center thickness on optical coherence tomography and fluorescein angiographic findings, before and after treatment. Results:The best corrected visual acuity and foveal center thickness improvements were statistically significant for all follow-up times (p < 0.05). Mean baseline best corrected visual acuity was 43.7 ± 20.1 letters and mean baseline foveal center thickness was 304.8 ± 127.9µm. Mean best corrected visual acuity was 55.6 ± 18.5, 52.1 ± 22.3, 52.1 ± 22.6, 50.3 ± 23.8 and 47.8 ± 24.5 for 12, 24, 36, 48 and 60 months of treatment, respectively. Mean foveal center thickness was 209.7 ± 86.2, 190.6 ± 76.1, 174.7 ± 60.6, 189.8 ± 96.7 and 159.4 ± 73.3 for the same follow-up times. Baseline best corrected visual acuity was the only predictive factor for better visual outcome (p < 0.001). Discussion/Conclusion: Intravitreal anti-VEGF injections in patients with myopic choroidal neovascularization yielded a significant and sustained functional and anatomic improvement. Randomized long-term clinical trials are needed to determine the sustained efficacy of these drugs.

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Long-term results of intravitreal bevacizumab for choroidal neovascularisation in pathological myopia

Cited by 42 publications

References 23 publications

Anti-VEGF Therapy in Myopic Choroidal Neovascularization: Long-Term Results

Anti-VEGF Therapy in Myopic Choroidal Neovascularization: Long-Term Results

Comparison of foveal-sparing with foveal-involving photodynamic therapy for myopic choroidal neovascularization

Avaliação dos Resultados do Tratamento Antiangiogénico na Neovascularização Coroideia Associada à Miopia Patológica

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