Ranibizumab For The Treatment Of Choroidal Neovascularization Secondary To Pathologic Myopia

Abstract

Purpose: : Pathologic myopia is the second cause of choroidal neovascularization after age related macular degeneration. The purpose of this study was to evaluate the efficacy and the safety of intravitreal injections of ranibizumab in choroidal neovascularization secondary to pathologic myopia.

Methods: : Monocenter retrospective analysis of consecutive patients treated by intravitreal injections of ranibizumab for choroidal neovascularization secondary to pathologic myopia, without any prior treatment. Fluorescein angiography and spectral-domain OCT (Cirrus SD-OCT, Zeiss) were performed for the diagnosis of choroidal neovacularization. Patients were treated with intravitreal ranibizumab (0.5 mg) as needed, after the first injection. EDTRS best-corrected visual acuity (BCVA), central retinal thickness (CRT) on spectral-domain OCT and fundus examination were performed monthly. Patients with an improvement of vision ≥10 letters and <10 letters were compared (Wilcoxon statistical test).

Results: : Forty seven patients with pathologic myopia (47 eyes), 34 women (72%) aged between 33 and 90 years (mean age: 66 years) were included. The mean number of injections was 2.5 with a mean follow-up of 14 months. The mean visual acuity at baseline was 20/80 (58 letters) and improved to 20/50 (67 letters) at the end of the study. BVCA improved by 15 letters in 21% of the patients and by 10 letters in 37%. The mean CMT decreased from 313 µm at baseline to 275 µm at the end of the study (p<0.001). No ocular or systemic adverse events were observed. BVCA improvement seemed to be more important when initial visual acuity was poor (p<0,001).

Conclusions: : Intravitreal ranibizumab results in an improvement of visual acuity in patients treated for choroidal neovascularization secondary to pathologic myopia with a reduced number of injections and a very limited number of recurrences after more than one year.

Keywords: myopia • choroid: neovascularization • retina