Abstract
Purpose: :
Dome-shaped macula is a recently described new type of myopic posterior staphyloma. It may be associated with atrophic changes in the retinal pigment epithelium and less frequently with myopic choroidal neovascularization (CNV). The purpose of this study was to evaluate the efficacy of intravitreal ranibizumab in the treatment of myopic CNV associated with dome-shaped macula
Methods: :
Retrospective, interventional case series study. Seventeen myopic eyes from 17 patients affected with dome shaped macula and subfoveal or juxtafoveal CNV were treated with three monthly intravitreal injections of 0,5 mg ranibizumab followed by a treatment as needed. Best corrected visual acuity (BCVA), fundus biomicroscopy, fluorescein angiography and optical coherence tomography (OCT) were performed at baseline and at the final examination. Changes in BCVA and OCT central retinal thickness were the main outcome measures.
Results: :
Mean age was 54,5 +/- 12,9 years and mean refractive error -9,3 +/- 3,9 D. Eight eyes (47%) had bilateral dome-shaped macula. The mean number of ranibizumab injections during a mean follow-up of 19,3 months (range 11 - 30) was 4,7 +/- 1,7 (range 2-7). The mean baseline logarithm of the minimum angle resolution (logMAR ) BCVA was 0,55 +/- 0,80 and improved to 0,29 +/- 0,49 at final examination (p < 0,001). The mean central retinal thickness was 383,5 +/- 122,7 at baseline and 277 +/- 57,2 at the final examination (p<0.001).
Conclusions: :
Intravitreal ranibizumab may be an effective treatment for myopic CNV related to dome shaped macula, resulting in functional and anatomic improvements. Further randomized studies are warranted.
Keywords: choroid: neovascularization • myopia • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)