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Michelle Carle, Homayoun Tabandeh, Francesco Boscia, David Boyer, Thomas Chu, Firas Rahhal; AntiVEGF treatment in myopic CNVM: Patient and treatment characteristics. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3862.
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Until recently, PDT and laser treatment were the mainstays of myopic CNVM, with poor results with subfoveal CNVM. More recently, Anti-VEGF agents have been used to treat CNVM in myopia, with excellent results, but there has been no consensus as to drug selection, drug dose, treatment protocol (including use of loading doses), and CNVM location for treatment. The purpose of is the current study was to review results of myopic CNVM treatment with anti-VEGF on a PRN treatment.
Retrospective chart review. Inclusion criteria: myopic CNVM in any macular location, treated with an anti-VEGF agent on a PRN regiment based on clinical, OCT, and FA findings. Exclusion criteria: CNVM from any other process than myopia.
42 eyes from 41 patients (27 female and 14 male) were included. Mean age was 54 years (range 25-82). Staphyloma was reported in 18 patients. Average follow up was 28 months (range 5-64) and in this time patients averaged 1.6 CNMV episodes (24 patients had one event, 12 patients had one recurrence, 5 patients had 2 recurrences, and one patient had 3 recurrences of CNVM). The average number of injections per patient was 4 injections in total, with 2.5 injections per episode. 35 patients were treated with bevacizumab exclusively, 6 were treated with ranibizumab exclusively, and one patient was treated with bevacizumab for one episode, ranibizumab for one episode, and aflibercept for one episode. BCVA at the time of hemorrhage was 20/50 or greater in 13, 20/60-20/100 in 11, 20/200-20/400 in 11, and CF in 7. Final BCVA was 20/50 or greater in 25, 20/60-20/200 in 6, 20/200-20/400 in 7, and CF in 4.
Myopic CNVM occurs in a younger age group than AMD (average in our series is 54 years). It responds well to PRN treatment without a loading dose. Overall, visual outcomes were favorable with more than half of patients having driving vision (>=20/50) in the treated eye after an average of 28 months of follow-up. Number of treatments per episode was low (2.5) with recurrence being on average 1.6 episodes over the total over 28 months.
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