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Malgorzata Woronkowicz, Susan Lightman, Robin Hamilton, Sophia Zagora, Oren Tomkins-Netzer; Comparison of anatomical and functional outcomes of treatment with bevacizumab and ranibizumab injections in eyes with myopic choroidal neovascularization (mCNV). Invest. Ophthalmol. Vis. Sci. 2018;59(9):4745.
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© ARVO (1962-2015); The Authors (2016-present)
Limited data exists regarding a comparison of efficacy of anti-VEGF agents in treatment of mCNV. We performed a retrospective clinical study to compare anatomical and functional outcomes of treatment with bevacizumab and ranibizumab injections.
We studied 85 eyes with mCNV treated with bevacizumab and 125 eyes treated with ranibizumab injections at Moorfields Eye Hospital between 2009 and 2016. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) on optical coherence tomography (OCT) scans were collected at baseline, after 3, 6, 12, 24 months and the last visit. Baseline OCT scans, photographs and fluorescein angiograms were analyzed to identify staphyloma, dome-shaped maculopathy, myopic tractional maculopathy, Fuchs’ spot, lacquer cracks, retinal haemorrhage, intra-/subretinal fluid, size and location of CNV and a grade of macular maculopathy. Generalized estimating equations analysis was used to study BCVA and CRT changes. Kaplan-Meier survival analysis and Cox proportional hazards models were applied to examine incidence and risk factors of a CNV recurrence.
Baseline BCVA was 0.62±0.04 logMAR and 0.61±0.04 logMAR in the bevacizumab and ranibizumab group, respectively and improved at the last visit by 0.22 logMAR (p<0.001) in the bevacizumab-treated eyes and 0.16 logMAR (p<0.001) in the ranibizumab-treated eyes. At baseline CRT was 309±10 µm and 326±9 µm in the bevacizumab and ranibizumab group, respectively and reduced by 63 µm (p<0.001) in the bevacizumab- and 52 µm (p<0.001) in the ranibizumab–treated eyes. There was no statistically significant difference between the groups regarding BCVA and CRT at any time point. The mean time to a CNV recurrence was 66.1±3.7 and 57.3±6.4 months in the bevacizumab and ranibizumab group, respectively (p=0.001). Risk factors for incidence of CNV recurrence included baseline CNV area (aHR 1.20, 95% CI: 1.0-1.32), subfoveal CNV location (aHR 2.13, 95% CI: 1.16-3.93) and treatment with ranibizumab (aHR: 2.31, 95% CI: 1.16-3.93).
In conclusion, this study shows that eyes with mCNV treated with bevacizumab and ranibizumab injections can achieve similar anatomical and functional improvement. However, treatment with ranibizumab can lead to a higher incidence of CNV recurrence.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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