Vascular endothelial growth factor inhibitors for predominantly Caucasian myopic choroidal neovascularization: 2‐year treatment outcomes in clinical practice: data from the Fight Retinal Blindness! Registry

Abstract

Purpose: To report the 24-month outcomes of vascular endothelial growth factor (VEGF) inhibitors for myopic choroidal neovascularization (mCNV) in predominantly Caucasian eyes in routine clinical practice. Methods: Retrospective analysis of treatment-na€ ıve eyes starting intravitreal injection of VEGF inhibitors of either bevacizumab (1.25 mg) or ranibizumab (0.5 mg) for mCNV from 1 January 2006 to 31 May 2018 that were tracked in the Fight Retinal Blindness! registry. Results: We identified 203 eyes (bevacizumab-85 and ranibizumab-118) of 189 patients. The estimated mean (95% CI) change in VA over 24 months for all eyes using longitudinal models was +8 (5, 11) letters with a median (Q1, Q3) of 3 (2, 5) injections given mostly during the first year. The estimated mean change in VA at 24 months was similar between bevacizumab and ranibizumab [+9 (5, 13) letters for bevacizumab versus +9 (6, 13) letters for ranibizumab; p = 0.37]. Both agents were also similar in the mCNV activity outcomes, treatment frequency and visit frequency. Conclusions: The 24-month treatment outcomes of VEGF inhibitors for mCNV were favourable in this largest series yet reported of predominantly Caucasian eyes in routine clinical practice, with approximately two lines of visual gain and a median of three injections given mostly during the first year. These outcomes are similar to those reported for predominantly Asian eyes. Bevacizumab appeared to be as safe and effective as ranibizumab.

Risk Factors of Vision Loss and Multiple Recurrences in Myopic Macular Neovascularization

“…Indeed, the risk of visual loss increased by 22% for each decade increase in age, regardless of the baseline BCVA and peak vision score. Previous authors 24 highlighted the association between older age and worse visual prognosis in mMNV eyes undergoing anti-VEGF treatment. We do not have data on the duration of mMNV, but older age may suggest long-standing neovascular lesions.…”

“…The reported rate of mMNV recurrences ranges between 23% and 62%. 17,[24][25][26] In this study, we estimated a global recurrence rate of 53% and a cumulative risk of three events by the ninth year. Our and previous data showed that recurrences have negative consequences on visual outcomes, accelerating visual loss.…”

Recurrence risk of myopic choroidal neovascularisation: a systematic review of current study

“…Conversely, elderly patients with myopia might experience more significant tissue damage resulting from myopic degeneration, as indicated by the characteristics observed in our patient population. The documented recurrence rate of mMNV varies between 23% and 62% 20–24…”

“…The documented recurrence rate of mMNV varies between 23% and 62%. [20][21][22][23][24] Collectively, these three studies provide valuable insights into the factors linked with recurrence in patients with m-CNV. The study by Jain et al 17 highlighted the number of injections received as a significant predictor of recurrence, emphasising the importance of appropriate treatment strategies and follow-up care.…”

Association between Obstetric Complications and Intravitreal Anti-Vascular Endothelial Growth Factor Agents or Intravitreal Corticosteroids

“…More than 1.2 million anti-VEGF IVTs were administered in France in 2020 [2]. Besides age-related macular degeneration (AMD), anti-VEGF agents are used for other indications-notably, in proliferative diabetic retinopathy [3], diabetic macular edema (DME) [4], retinal vein occlusion (RVO) [5], myopic choroidal neovascularization [6], inflammatory macular edema, inflammatory choroidopathy, and radiation maculopathy [7]. These retinal diseases may affect young people and therefore women of childbearing age.…”