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Anti-VEGF may be effective treatment for myopic choroidal neovascularization

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WAILEA, Hawaii — Myopic choroidal neovascularization, a continuum of myopia and pathologic myopia, is a rare but treatable cause of vision loss, according to a speaker here.

Approximately 41,000 people in the U.S. have myopic choroidal neovascularization (CNV). People with pathologic myopia between the ages of 45 and 64 years, especially women, are more likely to develop myopic CNV, Rishi P. Singh, MD, said at Retina 2018.

“We’re learning more about the primary prevention strategies, and I think the numbers will hopefully improve due to those strategies. I use OCT [angiography] and OCT to really help me guide my patients, especially in this population of people. Anti-VEGF at this point is usually safe and very effective at treating patients with this condition,” Singh said.

According to data in the IRIS Registry, anti-VEGF therapy was the primary treatment for myopic CNV patients in the United States in 2014. Several studies have shown the effectiveness of anti-VEGF therapy in treating myopic CNV, Singh said.

The REPAIR, RADIANCE and MYRROR studies all showed anti-VEGF therapy to be an effective treatment for the complication. In the REPAIR study, 86% of patients who received ranibizumab showed improvement in mean best corrected visual acuity scores, with 36.9% achieving a BCVA gain of 15 or more letters in the study eye. The RADIANCE study concluded ranibizumab therapy was superior to verteporfin photodynamic therapy in myopic CNV patients, and the MYRROR study showed aflibercept to be an effective treatment as well, Singh said.

“We have lots of good randomized clinical trials for ranibizumab and aflibercept for the treatment of mCNV,” he said. – by Robert Linnehan

Reference:

Singh RP. Facts, figures, and findings about myopic choroidal neovascularization. Presented at: Retina 2018; Jan. 14-19, 2018; Wailea, Hawaii.

Disclosure: Singh reports he is a consultant for Regeneron, Alcon, Shire, Optos and Genentech and does sponsored research with Regeneron, Apellis, Roche and Alcon.