Intravitreal anti-VEGF versus photodynamic therapy with verteporfin for treatment of myopic choroidal neovascularization.
OBJECTIVE
The purpose of this study was to compare visual outcomes after treatment with intravitreal antivascular endothelial growth factor (anti-VEGF) injection or photodynamic therapy (PDT) in patients with myopic choroidal neovascularization (CNV).


METHODS
One hundred and forty-two eyes of 128 consecutive patients treated with anti-VEGF (ranibizumab or bevacizumab) and/or PDT for myopic choroidal neovascularization were retrospectively reviewed. Patients were categorized into 3 groups: PDT (51 eyes), anti-VEGF (63 eyes), and a combination group (PDT with anti-VEGF) (28 eyes). Corrected visual acuity values at baseline and 3, 6, 9, and 12 months after treatment were compared.


RESULTS
The anti-VEGF group showed significant postoperative improvement in visual acuity compared with the PDT and combination groups (P = 0.01 and 0.04, respectively). The anti-VEGF group demonstrated visual improvement from baseline at every follow-up visit after treatment (P = 0.04, 0.02, 0.01, and 0.002, respectively). The anti-VEGF group showed visual improvement (Snellen equivalent) from 0.57 logarithm of the minimum angle of resolution (0.27) to 0.33 logarithm of the minimum angle of resolution (0.47) (P = 0.01). Furthermore, 98.4% of patients in the anti-VEGF group and 92.8% of those in the combination group lost <15 letters from baseline visual acuity compared with 72.6% in the PDT group (P = 0.001 and 0.02, respectively). In the anti-VEGF group, 39.7% of patients improved from baseline by 15 or more letters compared with 17.7% in the PDT group (P = 0.02) and 21.4% in the combination group (P = 0.07).


CONCLUSIONS
Intravitreal anti-VEGF injection is superior to PDT alone or a combination of PDT with anti-VEGF for treating myopic choroidal neovascularization.
Yoon
Jong Uk
JU
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Byun
Yeo Jue
YJ
Koh
Hyoung Jun
HJ
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D000069579:Ranibizumab; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology*; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D017319:Photosensitizing Agents; D011166:Porphyrins; D042461:Vascular Endothelial Growth Factor A; D000077362:Verteporfin; D000068258:Bevacizumab; D000069579:Ranibizumab