Abstract
Purpose:
To evaluate the visual outcome 24 months after intravitreal ranibizumab (IVR) for myopic choroidal neovascularization (mCNV), and to determine the effect of pre-treatment ocular factors on the visual outcome.
Methods:
Twenty-three eyes of 23 patients (4 men and 16 women, the mean age [± standard deviation] was 65.6 ± 11.1 years) with treatment-naiive mCNV were treated with IVR followed by pro re nata (PRN) therapy. The efficacy of IVR was evaluated by the best-corrected visual acuity (BCVA) at 3, 6, 12, and 24 months after the initial treatment. Stepwise multiple linear regression analyses were performed to evaluate the influence of pre-treatment factors (age, duration of symptom, axial length, pre-treatment BCVA in logarithm of the minimum angle of resolution [logMAR] units, pre-treatment CNV size, and pre-treatment CNV location as subfoveal or juxtafoveal) on the BCVA and the improvement of the BCVA at 24 months.
Results:
The mean pre-IVR BCVA was 0.59 ± 0.30 logMAR units and it improved to 0.36 ± 0.35 logMAR units after three month (P <0.005). The improvement was maintained at 24 months (0.35 ± 0.40 logMAR units, P <0.005). Of the 23 eyes, nine eyes (39.1 %) had IVR only once; mean number of injections was 2.2 ± 1.3 times at 24 months after the initial treatment. Stepwise regression analysis showed that the pre-IVR BCVA (standardized β =0.51, P<0.005) and CNV size (standardized β =0.46, P<0.005) significantly affected the BCVA after 24 months. The pre-IVR CNV location (juxtafoveal) was the only factor that affected the visual acuity improvement after 24 months (standardized β =0.54, P<0.05).
Conclusions:
IVR with PRN therapy for mCNV led to a sustained visual improvement for 24 months after initial treatment. Good pre-IVR BCVA and smaller CNV size were significant prognostic factors that predicts better visual acuity. Patients with juxtafoveal CNV had better visual recovery than those with subfoveal CNV.
Keywords: 453 choroid: neovascularization •
605 myopia •
561 injection