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Paolo Lanzetta, Daniele Veritti, Valentina Sarao, Sara Macor; Long-term Effect of Intravitreal Bevacizumab on Chorioretinal Atrophy Progression in Myopic Choroidal Neovascularization. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3856. doi: https://doi.org/.
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To investigate the long-term progression of chorioretinal atrophy (CRA) in patients with myopic choroidal neovascularization (mCNV) treated with intravitreal bevacizumab (IVB).
We retrospectively reviewed the clinical records of mCNV patients. Inclusion criteria were: (1) presence of subfoveal or juxtafoveal CNV, (2) refractive error ≥ 6.0 diopters or axial length ≥ 26.5 mm, (3) treatment with intravitreal injection of 1mg/0.04 ml of bevacizumab, (4) minimum follow-up of 24 months. Patients underwent digital fundus photograpy at baseline and every 12 months. Development or enlargement of CRA was judged and measured independently by two investigators (VS, SM), blinded to the other characteristics of patients. The main outcome was the change of total CRA area calculated as the sum of peripapillary atrophy area and CRA area at the posterior pole. Correlation between CRA progression and the number of injections was statistically analyzed.
Ninety-four eyes of 84 patients met the inclusion criteria. CRA did increase significantly (+7.82 mm2) (p< 0.0001) after two years of follow-up. A post hoc comparison test showed that the CRA change was significant at both 12 and 24 months (p< 0.001). Patients received an average of 4.3 treatments in 24 months. No correlation was found between the number of IVB and CRA enlargement at the posterior pole [p=0.85], in the peripapillary area (p=0.74), in both regions (p=0.83). Eighteen eyes reached 5 years of follow-up. After 60 months CRA enlarged significantly (+14.15 mm2) (p< 0.0001). The mean number of injections was 6.3 in 60 months. No correlation was found between the number of IVB and CRA progression at the posterior pole (p=0.13), in the peripapillary area (p=0.46), in both regions (p=0.29).
A significant enlargement of CRA frequently occurred in patients affected by mCNV and treated with IVB. This condition doesn’t seem to be influenced by the number of anti-VEGF intravitreal injections.
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