Long-term variable outcome of myopic choroidal neovascularization treated with ranibizumab

Abstract

Intravitreal ranibizumab resulted in long-term efficacy in the treatment of myopic CNV. However, some eyes may present a long-term relative decline in their initial visual gain.

Nine-Year Outcome of Ranibizumab Monotherapy for Choroidal Neovascularization Secondary to Pathologic Myopia

“…Silva et al [15] reported a mean of 3.6 intravitreal ranibizumab injections at the 12-month follow-up. Similar data were found in the study by Cohen et al [25] with a mean intravitreal ranibizumab number of 3.5 (range 1–12) over a mean follow-up of 39.3 months. Pece et al [38] reported 2.3 intravitreal injections in the ranibizu­mab subgroup during 20-month follow-up; similarly, Iacono et al [16] reported a mean of 2.5 intravitreal rani­bizumab injections over 18 months.…”

“…However, the present report revealed that visual acuity gain (13.7 ETDRS letters) at the 2-year follow-up was better than that in the series by Ruiz-Moreno et al [22]. These data are probably due to higher baseline visual acuity in that study (60.5 letters) compared to our series (56.2 letters), a lower baseline BCVA being more likely to show a higher improvement [25]. …”

“…However, it is noteworthy that the automatically calculated CFT on SD-OCT as a method for evaluating retreatment for PM is not recommended because atrophic changes could be part of the natural history of high myopia and not necessarily related to the treatment of mCNV [23, 39]. In our series, after the mean initial visual gain at 2 years, some eyes presented a progressive and long-term decline in BCVA, according to Cohen et al [25]. Structural SD-OCT analysis of these cases (35.29%, 6/17 eyes) revealed a completely disrupted ellipsoid zone with chorioretinal atrophy around a regressed mCNV (Fig.…”

“…Cohen et al [25] demonstrated a mean BCVA improvement of 7.63 ± 15.60 letters over time with a minimum follow-up of 24 months (39.3 ± 11.3 months, range 24–69). In 12% of the eyes, a relative decline in BCVA during the follow-up period was found, related to the extension of preexisting RPE atrophy, development of RPE atrophy around the CNV, or fibrotic subfoveal scarring [25]. In another study, Ruiz-Moreno et al [22] reported on the 6-year outcome of intravitreal ranibizumab for mCNV in 17 eyes.…”

Neun-Jahres-Ergebnisse zur Ranibizumab-Monotherapie der choroidalen Neovaskularisation infolge pathologischer Myopie

“…Verschiedene Langzeit-Nachbeobachtungsstudien konnten zeigen, dass die zunehmende Verschlechterung der bestkorrigierten Sehschärfe (BCVA, best corrected visual acuity) in myopen Augen durch eine Makulaatrophie bedingt ist [22,23,24,25,26]. In ihren Untersuchungen zur Beurteilung der Langzeitwirksamkeit von intravitreal verabreichten Anti-VEGF-Wirkstoffen als Primärtherapie bei mCNV zeigten Lai et al [27] sowie Franqueira et al [28], dass Ranibizumab eine erfolgreiche therapeutische Option darstellt und mit einer bis zu 2 bzw.…”