Abstract
Purpose :
To determine predictive factors for achieving good vision (20/40 or better) at months (M) 3 and 12 in patients with myopic choroidal neovascularization (mCNV) due to pathologic myopia, treated with ranibizumab (RBZ) in the phase 3, 12-month RADIANCE trial (NCT01217944).
Methods :
The RADIANCE trial compared verteporfin photodynamic therapy, the previous standard treatment for mCNV, vs 0.5 mg RBZ in patients with mCNV; RBZ re-treatment was guided by either visual stability (group I) or disease activity (group II). In this post hoc analysis, the association between baseline ocular/demographic characteristics and good vision outcomes at M3 and M12 was examined by univariate and multivariate analyses individually and on pooled groups I and II.
Results :
In the RADIANCE trial, 217 patients were randomized to groups I (n=104) and II (n=113), respectively. Treatment with RBZ resulted in rapid vision improvement, with both groups gaining > 2 lines of vision at M12. Based on the univariate analyses on pooled groups I and II, baseline BCVA, age, central retinal thickness (CRT), central foveal thickness (CFT), area of lesion, area of CNV, location of CNV, and CNV subtype in study eye were significant predictors for achieving 20/40 vision at M3 and M12 (all P < 0.05). The presence of intraretinal edema and fuchs spots (both P < 0.05) was associated with good vision at M3 only. Multivariate logistic regression analyses showed baseline BCVA, CFT, and area of lesion (all P < 0.05) were predictive of good vision at M3. For every 10-µm increase in CFT, the odds of good vision at M3 decreased by 5% (OR: 0.95, 95% CI: 0.91, 0.99). For every mm2 increase in area of lesion, the odds of good vision at M3 decreased by 29% (OR: 0.71, 95% CI: 0.57, 0.90). Only baseline BCVA (P < 0.0001) was predictive of good vision at M12. For every additional letter in baseline BCVA, the odds of good vision increased by 17% (OR: 1.17, 95% CI: 1.11, 1.24) for M3 and 13% (OR: 1.13, 95% CI: 1.09, 1.18) for M12.
Conclusions :
Several baseline factors in addition to prompt treatment with RBZ were useful in predicting a good response to treatment in patients with mCNV in the RADIANCE trial. These findings were consistent regardless of whether treatment was guided by visual stability or disease activity. There will be more analyses in the near future to assess predictive factors of good vision.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.