The clinical effects and mechanism of action of ranibizumab in treating myopic choroidal neovascularization

Abstract

Objective To investigate the clinical effects and factors influencing repeated intravitreal injections of ranibizumab among patients with choroidal neovascularization (CNV) secondary to pathologic myopia. Methods There were 39 patients with myopic CNV and a control group of 10 cataract patients. Logarithm of the minimum angle of resolution units (logMAR) was adopted to evaluate best-corrected visual acuity (BCVA), while the measurement of central macular thickness was made via optical coherence tomography. Luminex xMAP suspension array was adopted to collect and analyze plasma and aqueous humor samples to compare cytokine concentrations between the two groups and assess changes after intravitreal ranibizumab injections. Additionally, BCVA values and CMT were monitored. Results A great diversity in the BCVA values and CMT was found after intravitreal ranibizumab injections (p<0.05 for both). The study group showed greatly higher plasma concentration of vascular endothelial growth factor-A than the cataractgroup (p<0.05). The research group (p<0.05 for both) showed greatly lower epidermal growth factor (EGF) and angiopoietin-2 concentrations. In the aqueous humor, the study group showed greatly higher concentration of fibroblast growth factor (FGF)-2 than the cataract group (p<0.05), and the research group (p<0.05 for both) displayed greatly lower concentrations of EGF and VEGF-A. The decrease in average VEGF-A contents was significant by comparing with baseline at both 1 month (p<0.05) and 2 months (p<0.05), and the reduction in mean VEGF-D and endoglin contents compared to baseline at 2 months were significant (p<0.05 for both), and were significant when compared at 1 month to 2 months (p<0.05 for both). The average EGF contents were significantly higher at 2 months than at baseline (p<0.05). Conclusion Ranibizumab had obvious effects on myopic CNV. For different individuals, different treatment projects should be chosen.