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Yukari Jo, Yasushi Ikuno, Fumi Gomi, Miki Sawa, Kohji Nishida; FACTORS ASSOCIATED WITH RECURRENT CHOROIDAL NEOVASCULARIZATION DUE TO PATHOLOGICAL MYOPIA TREATED WITH INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4951.
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Choroidal neovascularization (CNV) is a major cause of social blindness in highly myopic eyes. Recently, anti-vascular endothelial growth factor (VEGF) reagent is commonly used for intra-vitreal injection and found to regress the CNV. The recurrence is common and more injections are needed. However, it is still uncertain what factors are related with the recurrence of CNV. We attempted to find out the associated factors for recurrence of myopic CNV (mCNV).
We retrospectively reviewed the records of 58 eyes of 55 patients with treatment-naïve mCNV that were treated with intravitreal anti-VEGF injections at Osaka University Hospital, Osaka, Japan, between November 2005 and May 2013. Fifty-eight eyes were treated with 1 mg of bevacizumab and one with 0.5 mg of ranibizumab. The eyes were retreated if physicians observed persistent/recurrent subretinal fluid, hemorrhage, or retinal edema. The treatments were not switched in any eyes during follow-up. The minimal follow-up period was at least 2 years. The greatest linear diameter (GLD) was measured on fluorescein angiography images.
The mean patient age was 64.4 ± 9.3 (range, 42-83) years, the mean refractive error (RE) was -12.6 ± 3.4 diopters, and the mean axial length (AL) was 29.30 ± 1.8 mm. The CNV recurred in 20 (34%) eyes during follow-up. Age (P=0.96), gender (P=0.44), initial visual acuity (VA) (P=0.83), position of CNV (sub-, juxta-, or extra-foveal) (P=0.45), AL (P=0.90), RE (P=0.50), baseline GLD (P=0.91) were not correlated significantly with the CNV recurrences. However, the number of injections before recurrence was greater (P=0.02) and the best VA during follow-up was significantly better (P=0.03) in eyes with a recurrence of CNV.
It is difficult to predict the recurrence of mCNV after anti-VEGF treatment. However, eyes with more frequent injections and more favorable VA are key factors.
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