Three initial anti-VEGF injections may benefit eyes with myopic CNV

Am J Ophthalmol. 2011;151(3):529-534.

In patients who receive intravitreal ranibizumab for myopic choroidal neovascularization, best corrected visual acuity at baseline and location of CNV may be predictive factors for visual outcome, while location of CNV and prior treatment may indicate a need for re-treatment, a study found.

The prospective, interventional, nonrandomized case series analyzed 67 eyes that were treated with three Lucentis (ranibizumab, Genentech) injections, given monthly.

Mean follow-up was 15.9 months, mean number of injection was 4.2, and there were no major complications. Mean BCVA improved by 12.5 letters after three injections and 12 letters by the study's conclusion. BCVA improved for 79.1% of eyes overall, with 53.7% of eyes requiring only the first three injections, and the mean reduction in central macular thickness was 93.6 µm.

Regression analysis showed BCVA (P = .006) and CNV location (P = .026) to be significantly correlated with visual outcome, while CNV location (P = .023) and prior treatment (P = .047) were associated with the number of injections.

Despite an observed increase in chorioretinal atrophy, a mean BCVA improvement lasting 24 months suggested that atrophy has a limited negative effect, the study authors said. They also believe that the study results support safe and efficacious use of three initial ranibizumab injections to treat myopic CNV.