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B. Voykov, F. Ziemssen, M. Voelker, W. Inhoffen, K. Bartz-Schmidt, F. Gelisken; Intravitreal Bevacizumab for Choroidal Neovascularisation in Pathological Myopia: 2-Years Results. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2281.
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© ARVO (1962-2015); The Authors (2016-present)
To report the 2-years results of functional and morphological response to intravitreal bevacizumab treatment for choroidal neovascularisation (CNV) secondary to pathological myopia.
In this retrospective study, 11 eyes from 11 consecutive patients with CNV secondary to pathological myopia were included who underwent intravitreal bevacizumab injections (1.25mg) between October 2005 and November 2008. All eyes had no previous record of other treatment (i.e. surgical extraction, macular translocation, photodynamic therapy with verteporfin or argon laser photocoagulation). Best-corrected visual acuity (ETDRS) was assessed at baseline and follow-up and converted to logMAR acuity for analysis. Fluorescein angiography was available for all eyes at baseline and was performed afterwards at the discretion of the examiners. All patients had repeated optical coherence tomography (OCT) measurements at baseline and follow-up examinations. Indication for re-treatment was adopted from the PrONTO study with loss of 5 letters in the presence of leakage, increase in retinal thickness of more than 100µm or signs of CNV activity as bleeding or increase in CNV size.
11 patients (8 female, 3 male) were treated by intravitreal bevacizumab injections (average 2.1; range 1-5). Mean follow-up was 762 days (CI-95%: 696-829 days). At 2-year follow up 9 eyes (81.8%) had a visual improvement of 1 line or more and 5 eyes (45.5%) gained 3 or more lines. One eye showed a worsening of one line and one eye had a worsening of more than 3 lines. The mean logMAR visual acuity showed a trend of improvement from 0.7 at baseline to 0.5 at end point follow up (p<0,06). Mean retinal thickness at the final examination (264µm) was significantly lower than baseline (432µm; p<0,001). Retinal thickness at the final examination correlated with visual acuity for the age group 65 years. No complications or adverse effects were observed.
In accordance to previous short term studies, our results show that intravitreal bevacizumab injections can prevent vision loss in the majority of eyes with CNV secondary to pathological myopia over a period of 2 years. In general, retinal thickness at the final examination was not correlated to visual acuity outcome. However, a subgroup analysis for patients younger than 65 years showed a significant correlation. Analysis of larger controlled and statistically more powerful studies is suggested to weight the functional and morphological outcome of intravitreal bevacizumab treatment for CNV secondary to pathological myopia.
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