Purpose:
To compare the functional and morphologic choroidal changes secondary to intravitreal pan anti-VEGF versus anti-VEGF165 in myopic eyes complicated by choroidal neovascularization (mCNV).
Methods:
Retrospective comparative study, including mCNV treated with 3 consecutive injections of pegaptanid sodium (IVP; 0.3 mg/ 0.05 ml) or ranibizumab (IVR; 0.5 mg/ 0.05 ml) at baseline, 6th week and 12th week. We recorded the best-corrected visual acuity (BCVA), microperimetry (MP), fluorescein angiography and spectral domain optical coherence tomography performed at the following intervals: baseline, 18-, 24-, 36- weeks. Retinal and choroidal thicknesses were measured in the macular region. The morphological type of posterior staphyloma (according to Curtin’s classification) and the presence of lacquer cracks were also recorded.
Results:
Forty-six eyes were included in the study. A significant decrease of central retinal thickness occurred in both groups whereas no changes in choroidal thickness were measured through the follow-up. Treatment resulted in complete absence of fluorescein leakage in 92% of IVP group and 95% of IVR group. An improvement of functional parameters was recorded in all patients (BCVA from 23.4 ± 7.8 letters to 41.6 ± 8.2 letters, p< 0.0001; MP from 9.60 ± 1.9 dB to 11.7 ± 2.1 dB, p < 0.01). Neither ocular nor systemic side effects were observed. The changes between IVP and IVR were not significant at any time. No correlations were found between tomographic and angiographic choroidal changes and BCVA in both groups. The recurrence rate was related to type 3 posterior staphiloma.
Conclusions:
Selective inhibition of VEGF-165 isoform by IVP is as effective as IVR treatment for mCNV in terms of morphological of choroid and functional outcomes. The presence of type 3 posterior staphiloma and lacquer cracks were significant predictors of mCNV recurrence.
Keywords: myopia • choroid: neovascularization • choroid