Prognostic factors of eyes with naïve subfoveal myopic choroidal neovascularization after intravitreal bevacizumab.

Abstract

PURPOSE:

To determine the efficacy of 1 intravitreal bevacizumab injection followed by pro re nata (1 + PRN) injection in cases of subfoveal myopic choroidal neovascularization (CNV) and to identify CNV-recurrence-related prognostic factors.

DESIGN:

Retrospective observational case series.

METHODS:

In total, 103 eyes of 89 consecutive naive patients who had subfoveal myopic CNV and had been followed-up for at least 2 years were included. Of those eyes, 24 had recurrences. The remaining eyes were stable after the initial treatment.

RESULTS:

The average patient age was 51.1 ± 15.2 years. The average follow-up duration was 44.1 ± 12.7 months. At baseline and at the 1-year, 2-year, and final visits, the average best corrected visual acuities (BCVAs) were 0.57 ± 0.45, 0.38 ± 0.51, 0.40 ± 0.52, and 0.41 ± 0.41 logMAR, respectively. The recurrence rate during follow-up was 23.3%. The BCVA improved by 0.2 logMAR after 2.7 injections in the eyes without recurrence but by only 0.08 logMAR after 6.9 injections in the eyes with recurrence. In univariate analysis, recurrence was associated with older age, more myopic refraction, thinner choroid, larger CNV lesions, and subfoveal hemorrhage at baseline. In multivariate analysis, only baseline CNV lesion size associated significantly with CNV recurrence (P = 0.002). Recurrence, baseline BCVA, choroidal thickness, and CNV size associated significantly with final BCVA (P = 0.026, <0.0001, 0.007, and 0.002, respectively). Baseline choroidal thickness, CNV size, age, and presence of lacquer cracks associated significantly with injection number (P < 0.0001, <0.0001, 0.026, and 0.035, respectively).

CONCLUSIONS:

1 + PRN intravitreal bevacizumab monotherapy effectively stabilized subfoveal myopic CNV. The CNV size, the baseline BCVA, and the choroidal thickness were the main prognostic factors of subfoveal myopic CNV after 1 + PRN injection of bevacizumab.

• Authors: Hyun Seung Yang, June-Gone Kim, Jee Taek Kim, Soo Geun Joe
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 156 Issue 6 Pg. 1201-1210.e2 (Dec 2013) ISSN: 1879-1891 [Electronic] United States
• PMID: 24075429 (Publication Type: Comparative Study, Journal Article, Observational Study)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• Bevacizumab

Topics

• Angiogenesis Inhibitors (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Bevacizumab
• Choroidal Neovascularization (diagnosis, drug therapy, etiology)
• Female
• Fluorescein Angiography
• Follow-Up Studies
• Fovea Centralis (pathology)
• Humans
• Intravitreal Injections
• Male
• Middle Aged
• Myopia, Degenerative (complications, diagnosis, drug therapy)
• Prognosis
• Recurrence
• Retreatment
• Retrospective Studies
• Tomography, Optical Coherence
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity (physiology)