Prognostic Factors for Visual Outcome After Intravitreal Anti-Vegf Injection for Naive Myopic Choroidal Neovascularization

Abstract

Purpose: The aim of this study was to evaluate the prognostic factors of visual outcome after intravitreal anti-vascular endothelial growth factor injection in patients with myopic choroidal neovascularization (CNV).Methods: Forty eyes of 40 consecutive patients with myopic CNV who had received intravitreal ranibizumab or bevacizumab injections were retrospectively reviewed. Baseline visual acuity, presence of lacquer crack, dark rim, peripapillary choroidal atrophy size, and location of myopic CNV were evaluated using fluorescein angiography and indocyanine green angiography.Results: The logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) at 12 months after treatment was 0.23 6 0.28, and there was a significant improvement compared with the baseline BCVA (P = 0.001). After multiple linear regression analysis, baseline BCVA, presence of lacquer crack extending the fovea, and peripapillary choroidal atrophy size were the factors that significantly correlated with BCVA at 12 months (P = 0.001, P = 0.04, and P = 0.04). For mean change in BCVA over 12 months, there were also significant correlations with baseline BCVA, lacquer crack extension to the fovea, and peripapillary choroidal atrophy size (P = 0.001, P = 0.03, and P = 0.03). The mean number of anti-vascular endothelial growth factor injections was 2.8 6 2.0 over 12 months. Complete resolution of myopic CNV was noted in 22 eyes (55.0%) after initial first injection, and no additional treatment was required in 12 eyes (30%).Conclusion: Better baseline BCVA, lacquer crack extension to the fovea, and peripapillary atrophy were negative prognostic factors of visual acuity improvement, and there was quite a promising result of anti-vascular endothelial growth factor treatment in patients with myopic CNV.RETINA 32:949-955, 2012

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

“…Our results showed that among the pretreatment factors analysed, baseline BCVA was the main variable influencing the BCVA 2 and 3 years after treatment. Therefore, patients with a higher BCVA at baseline had a better BCVA after treatment, as described by other authors [22,31]. This fact may be associated with minor initial damage to the photoreceptors in these patients.…”

“…Age was another factor independently correlated with BCVA outcome at 3 years, a finding consistent with results of a prospective study by Gharbiya et al [24], in which the authors reported that for each 1-year increase in baseline patient age there was a mean decrease in final BCVA of 0.39 letters. However, the effect of age on the visual prognosis of mCNV eyes treated with anti-VEGF agents has not been as well described as its influence on mCNV eyes treated with PDT [22,31]. A possible explanation is that PDT may provoke some damage to the retina or retinal pigment epithelium, and that the ability to recover from such damage can be affected by a patient's age.…”

Long-term outcome of intravitreal anti-vascular endothelial growth factor therapy with bevacizumab or ranibizumab as primary treatment for subfoveal myopic choroidal neovascularization

“…14,27 Previous studies that have evaluated the use of anti-VEGF therapy in myopic CNV were also rather heterogeneous, as the studies have included prior treated eyes as well as non-subfoveal CNV. [28][29][30] In order to further assess the long-term efficacy of anti-VEGF therapy for myopic CNV, we evaluated the 2-year outcomes in the use of intravitreal bevacizumab and ranibizumab as the primary treatment for subfoveal myopic CNV. We also evaluated the prognostic factors that might influence the visual outcomes following anti-VEGF therapy for myopic CNV.…”

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

“…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…”