Aflibercept as primary treatment for myopic choroidal neovascularisation: a retrospective study

Abstract

AimThe aim of this study is to evaluate long-term efficacy of intravitreal injections of aflibercept as primary treatment for subfoveal/juxtafoveal myopic choroidal neovascularisation (CNV).MethodsThirty-eight treatment-naive eyes of thirty-eight patients with subfoveal/juxtafoveal myopic CNV received initial intravitreal aflibercept injections and were followed for at least 18 months. Aflibercept was applied again for persistent or recurrent CNV, as required. Statistical analysis was carried out using SPSS.ResultsMean patient age was 45.8 years, and mean eye refractive error was −7.79 D. For the total patient group (n=38 eyes), mean logMAR best-corrected visual acuity (BCVA) significantly improved from 0.69 at baseline to 0.15 at 18 months (P<0.01). Over half of the treated eyes obtained resolution with one aflibercept injection. Patients were also grouped according to age, as <50 years (n=20 eyes) and ≥50 years (n=18 eyes). Mean BCVA improvement was significantly greater in eyes of the younger myopic CNV group, compared with those of ≥50 years (0.21 vs 0.35; P<0.05). The mean number of aflibercept injections was 1.8 for the <50 years myopic CNV group, and 3.6 for the ≥50 years myopic CNV group (P<0.001). Correlation between spherical equivalent refraction and final visual acuity reached statistical significance only for the <50 years myopic CNV group (P<0.001; Levene's correlation).ConclusionsIntravitreal aflibercept provides long-term visual acuity improvement in myopic CNV. The <50 years old myopic CNV group had significantly fewer injections, with greater visual acuity improvement. Intravitreal aflibercept in myopic CNV does not require the three-injection loading phase used for aflibercept treatment of neovascular age-related macular degeneration.

Intravitreal ziv-aflibercept for the treatment of choroidal neovascularisation associated with conditions other than age-related macular degeneration

“…Bruè et al noted significant improvement in visual acuity following as-needed aflibercept injections in eyes with CNV associated with PM. During the 18-month treatment period, the CNV resolved in 50% of the patients after a single injection (range, 1–5) 7. Broadhead and Chang reported good responses to single intravitreal injections of aflibercept in two patients with CSCR-related CNV who were refractory to photodynamic therapy, ranibizumab and bevacizumab.…”

Intravitreal bevacizumab monotherapy in myopic choroidal neovascularisation: 5-year outcomes for the PAN-American Collaborative Retina Study Group

“…Brue et al evaluate long-term efficacy of intravitreal injections of aflibercept as primary treatment for myopic CNV 23. They reported that less than 50 years old myopic CNV group had significantly fewer injections, with greater visual acuity improvement.…”

Intravitreal Conbercept for choroidal neovascularisation secondary to pathological myopia in real-life setting in China

“…This resolution rate is markedly lower than the resolution rate of 54.7% by Bruè C et al [21],who focused on both subfoveal and extrafoveal myopic CNV. In addition, 2 eyes (5.9%) showed recurrence, those patients who required relatively more frequent IVC had larger CNVs.…”