Six-Year Outcomes of Intravitreal Bevacizumab for Choroidal Neovascularization in Patients With Pathologic Myopia

Kasahara, Kaori; Moriyama, Muka; Morohoshi, Kei; Yoshida, Takeshi; Simada, Noriaki; Nagaoka, Natsuko; Yokoi, Tae; Shinohara, Kosei; Kaneko, Yuichiro; Suga, Mitsuki; Ohno‐Matsui, Kyoko

doi:10.1097/iae.0000000000001313

Cited by 46 publications

(39 citation statements)

References 16 publications

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“…Anti-VEGF therapy is the first-line therapy for mCNV, because the effect of PDT, which is an effective treatment for AMD, is limited to maintaining vision due to the high rate of CRA progression [5,23,24]. However, several investigators have reported that the VA improved significantly from baseline just after treatment, was maintained for 3 or 4 years, then declined slightly thereafter mainly due to CRA progression [6][7][8][9][10][11][12]. Oishi et al evaluated the long-term outcomes in 22 eyes with mCNV after intravitreal injection of bevacizumab (IVB) (Avastin, Genentech) for at least 4 years [9].…”

Section: Discussionmentioning

confidence: 99%

“…The long-term visual prognosis is poor without treatment [4]. Although various treatments, including laser photocoagulation, macular translocation, surgical CNV removal, photodynamic therapy (PDT), and anti-vascular endothelial growth factor (anti-VEGF) therapy, have been performed [5], the long-term visual outcomes are extremely poor primarily due to the development of chorioretinal atrophy (CRA) around the regressed CNV [6][7][8][9][10][11][12]. To improve the long-term visual outcomes of mCNV, treatments are needed that also prevent development of CRA.…”

Section: Introductionmentioning

confidence: 99%

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Effect of intravitreal injection of aflibercept or ranibizumab on chorioretinal atrophy in myopic choroidal neovascularization

Sayanagi

Uematsu

Hara

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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Purpose To compare chorioretinal atrophy (CRA) progression in myopic choroidal neovascularization (mCNV) between intravitreal injections of ranibizumab (IVR) and aflibercept (IVA) in the eyes with mCNV. Methods Thirty eyes (28 patients) with treatment-naïve mCNV were included in this study. IVR or IVA was administered for up to 1 year. The best-corrected visual acuity (BCVA) was measured, and fundus photographs and fundus autofluorescence were obtained before and 1, 3, 6, and 12 months after the initial treatment. The clinical characteristics including the macular choroidal thickness in various areas and CRA progression were compared between the drugs. The clinical characteristics and macular choroidal thicknesses were compared between eyes with and without CRA progression. Results The BCVA improved significantly (p < 0.05 for all comparisons) from 0.44 to 0.26, 0.19, 0.20, and 0.17 after 1, 3, 6, and 12 months, respectively. CRA progressed in 12 (40%) eyes over 1 year. The CRA progression did not differ significantly between aflibercept and ranibizumab. The foveal choroid was significantly (p = 0.0043) thinner in aflibercept-treated eyes compared with ranibizumab-treated eyes at 1 year. Subfoveal CNV tended to cause CRA progression more frequently at 1 year, although this did not reach significance. Conclusions IVA to treat mCNV caused more severe thinning of the foveal choroid than ranibizumab; however, no significant difference was seen in CRA progression between the drugs and the choroidal thickness should not be associated with CRA progression. The CNV location may predict CRA progression after anti-vascular endothelial growth factor therapy for mCNV.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of intravitreal injection of aflibercept or ranibizumab on chorioretinal atrophy in myopic choroidal neovascularization

Sayanagi

Uematsu

Hara

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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“…The efficacy and safety of IVR for mCNV have been demonstrated in several small prospective and retrospective studies (19)(20)(21)(22). There are a few reports on longterm outcomes of anti-VEGF therapy in mCNV in the literature (23)(24)(25). The aim of this study was to report the long-term anatomical and visual outcomes of IVR monotherapy in naive CNV caused by myopia.…”

Section: Introductionmentioning

confidence: 96%

Intravitreal Ranibizumab Therapy for Choroidal Neovascularization Secondary to Pathological Myopia: 3 Year Outcome

Perente¹

2018

Beyoglu Eye J

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Objectives:The purpose of this study was to report the functional and anatomical results of intravitreal ranibizumab (IVR) injections administered for myopic choroidal neovascularization (mCNV) secondary to pathological myopia. Methods: In this retrospective study, 32 eyes of 32 mCNV patients were evaluated. After a first IVR injection, patients were followed up and treated with an as-needed monthly regime. Best-corrected visual acuity and optic coherence tomography (OCT) findings were evaluated at baseline and then monthly. The reinjection criteria were a reduction in visual acuity and/or an increase in central macular thickness measured with OCT. Results: The mean age of the patients was 57.7±14.6 years, and the mean axial length was 27.8±1.3 mm. The mean visual acuity improved significantly from 46.4±9.7 letters at baseline to 54.1±9.5 letters at the last follow-up visit (p<0.05). The mean central macular thickness decreased from 301.4±11.7 μm at baseline to 258.8±12.5 μm at the last visit (p>0.05). The mean number of injections was 3.5±1.1, 2.3±0.9, and 1.7±0.8, at 12, 24, and 36 months, respectively. Conclusion:The results of this study indicated that IVR injections provided a significant long-term visual and anatomical benefit in cases of mCNV with few injections.

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“…[1][2][3] Previously, the standard treatment option for myopic CNV is photodynamic therapy (PDT); however, the patients treated with PDT have limited long-term visual outcomes. [4] Recently, anti-vascular endothelial growth factor (anti-VEGF) drugs such as ranibizumab, [5][6] bevacizumab, [7] and aflibercept [8] have been used to treat myopic CNV with promising results. The study of PDT versus intravitreal bevacizumab (IVB) provided evidence for the superiority of intravitreal bevacizumab over 3 PDT in treating myopic CNV.…”

Section: Introductionmentioning

confidence: 99%

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

Nie

Wang

Yang

et al. 2020

Preprint

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Background: To evaluate the 12-month efficacy and safety of intravitreal conbercept for myopic choroidal neovascularization (CNV). Methods: A retrospective, observational study. Thirty-four eyes of 34 pathologic myopic patients with CNV were treated with intravitreal conbercept (IVC) 0.5 mg with a follow up of 12 months. After the first injection, administration of conbercept followed a pro re nata (PRN) regimen. Outcomes included best corrected visual acuity (BCVA), central retinal thickness (CRT), CNV size, the total number of treatments, and adverse events. Results: The mean patient age was 55.88 ± 16.17 years, and mean eye spherical equivalent was − 8.72 ± 3.75 D. The mean number of IVC over 12 months was 2.12 ± 0.69. Overall, best-corrected visual acuity（BCVA）improved from 0.86 ± 0.33 logMAR at baseline to 0.44 ± 0.32 logMAR at month 12 ( P < 0.001 ), mean improvement of vision was 4.12 ± 2.69 Snellen lines . Mean central retinal thickness reduced from 285.9 ± 104.6 μm at baseline to 192.1 ± 97.5 μm at month 12 (P < 0.001). Mean CNV size decreased from 0.52 ± 0.38 mm 2 at baseline to 0.31 ± 0.19 mm 2 at 12 months (P < 0.05). All the 34 eyes had reduced or stable size of CNV, thirty-two eyes (94.12%) showed absence of CNV leakage at the end of the study period. No severe complications were observed. Conclusion: Intravitreal conbercept 0.5mg was safe and effective for treatment of myopic CNV over 12 months in real-life setting.

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Six-Year Outcomes of Intravitreal Bevacizumab for Choroidal Neovascularization in Patients With Pathologic Myopia

Abstract: The significant correlation between the BCVA at 6 years and the size of the macular atrophy indicates that treatments to prevent the development of macular atrophy are important for the long-term visual outcome in eyes with active CNV.

Cited by 46 publications

References 16 publications

Effect of intravitreal injection of aflibercept or ranibizumab on chorioretinal atrophy in myopic choroidal neovascularization

Effect of intravitreal injection of aflibercept or ranibizumab on chorioretinal atrophy in myopic choroidal neovascularization

Intravitreal Ranibizumab Therapy for Choroidal Neovascularization Secondary to Pathological Myopia: 3 Year Outcome

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

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