Myopic choroidal neovascularization treated by intravitreal bevacizumab: comparison of two different initial doses

Ruiz-Moreno, José M.; Montero, Javier A.; Amat-Peral, Pedro

doi:10.1007/s00417-010-1599-z

Cited by 32 publications

(32 citation statements)

References 27 publications

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“…12 O bevacizumab é um anticorpo monoclonal, humanizado, recombinante, 33 desenvolvido para tratamento endovenoso, como adjuvante da quimioterapia, na terapia de neoplasias sólidas metastizadas. Assume particular interesse no tratamento da NVC na miopia, pelos resultados promissores descritos em séries de casos e alguns ensaios clínicos, 1,6,8,11,13,[34][35][36] aliados a um preço significativamente mais baixo quando comparado com o ranibizumab, permitindo deste modo que a terapêutica seja acessível a um maior número de doentes. 10 Verificámos que os agentes antiangiogénicos permitiram uma melhoria significativa e sustentada na MAVC e na EF, até aos 60 meses de tratamento.…”

Section: Discussionunclassified

“…1,2 Define-se como um erro refrativo de pelo menos -6 dioptrias, acompanhada de alterações degenerativas da retina, esclera e coróide típicas. [3][4][5] Cerca de 10% dos doentes desenvolvem neovascularização coroideia (NVC), a mais frequente complicação associada e que pode ser responsável pela perda severa e progressiva de visão, sobretudo em jovens e adultos de meia-idade na fase mais produtiva das suas vidas.…”

Section: Introductionunclassified

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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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Section: Discussionunclassified

Section: Introductionunclassified

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

et al. 2014

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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%

“…More recently, studies on treatment of myopic CNV with intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents have reported good clinical outcomes. [6][7][8][9][10][11][12] However, anti-VEGF agents are associated with systemic risks such as cerebrovascular accidents and other arterial thromboembolic events, especially for patients with pre-existing disease. [13][14][15][16] In addition, intravitreal injections carry the risk of infectious endophthalmitis.…”

Section: Introductionmentioning

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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“…All eyes were initially treated according to a 1+PRN dosing regimen based on the retreatment criteria mentioned above. In a prospective and multicentre study, Ruiz-Moreno et al [35] compared the 1+PRN treatment protocol with the alternative loading dose regimen of 3 consecutive monthly injections for mCNV and showed that both schedules achieved similar results in final BCVA outcome, even though the 1+PRN protocol resulted in a lower number of injections with a higher rate of recurrences during the first year.…”

Section: Discussionmentioning

confidence: 99%

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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Myopic choroidal neovascularization treated by intravitreal bevacizumab: comparison of two different initial doses

Abstract: Both schedules achieved similar results improving BCVA, though the second group required a lower number of injections, showing a higher rate of recurrences during the first year.

Cited by 32 publications

References 27 publications

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

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

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

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

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