Factors associated with visual outcome after anti-vascular endothelial growth factor therapy in myopic choroidal neovascularization

Abstract

Purpose : To determine factors associated with visual outcome after anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with myopic choroidal neovascularization (mCNV).

Methods : Medical charts of the 24 eyes of 24 patients who were diagnosed with mCNV at the Medical Retina Division Clinic of the Department of Ophthalmology, Keio University Hospital between May 2014 and December 2017, and treated with either intravitreal ranibizumab (IVR) or aflibercept (IVA) monotherapy in a PRN regimen for 12 months were retrospectively analyzed. All the patients were treatment naïve and basically followed-up in every month. Best-corrected visual acuity (BCVA) was converted into LogMAR score. In the optical coherence tomography (OCT) images, the mCNV height was measured using scale bars of the OCT system, and mCNV intensity was evaluated by measuring the intensities of mCNV, vitreous cavity (VC), and the retinal pigment epithelium (RPE) using ImageJ software with normalization as follows; adjusted mCNV intensity = 100 x (mCNV intensity – VC intensity)/ (RPE intensity – VC intensity). The study adhered to the tenets of the Declaration of Helsinki, was registered as UMIN000007649, and was approved by the Ethics Committee of Keio University School of Medicine; approval number, 20100003. Informed consent was obtained from all subjects.

Results : Of 24 patients, 8 (33%) were man and mean age was 70.6 ± 10.1. Overall, mean BCVA was 0.31 ± 0.36 at baseline and 0.17 ± 0.36 at month 12, and significantly improved. In 15 patients (62.5%), BCVA was better than 0.097 (0.8 in decimal score, 20/25 in Snellen Chart) at month 12. These eyes had better BCVA (P=0.017), and lower normalized mCNV intensity (P=0.047), at baseline compared with the others who had worse BCVA at month 12. There was no difference in the mCNV height at baseline between the groups.

Conclusions : The findings in this study suggested that patients with mCNV may have better BCVA after 12 months of anti-VEGF therapy in a PRN regimen, if the patients were treated before their BCVA became worse, and if the mCNV had less intensity in OCT images at baseline, although further studies are required.

This is a 2020 ARVO Annual Meeting abstract.