Long-term results of intravitreal bevacizumab for choroidal neovascularisation in pathological myopia.
OBJECTIVE
To evaluate the long-term results and prognostic factors of intravitreal bevacizumab (IVB) for myopic choroidal neovascularisation (mCNV).


METHODS
Thirty-two eyes of 30 patients with mCNV were included in a prospective case series. Treatment consisted of three monthly 1.25 mg IVB injections. Best corrected visual acuity (BCVA) and CNV area were compared before and after treatment. Prognostic factors included in the regression analyses were age, axial length, baseline BCVA, pretreatment CNV area, CNV location and peripapillary atrophy area.


RESULTS
Results were evaluated at 2 years for 32 eyes and at 3 years for 27 eyes. Mean (± SD) baseline BCVA had improved significantly from 30.1 (± 15.6) letters to 45.4 (± 13.0) letters at 3 years (p<0.0001), with a better outcome in eyes with juxtafoveal CNV (40.4 ± 13.5 vs. 54.0 ± 5.8, p=0.001). Baseline BCVA correlated positively with final BCVA (β= 0.560, p=0.001), while age showed a negative correlation (β= -0.399, p=0.01). CNV area decreased from 0.63 (± 0.71) mm(2) at baseline to 0.40 (± 0.57) mm(2) at 3 years (p<0.0001). Peripapillary atrophy area was the only significant contributing determinant for re-treatment (OR 1.20, 95% CI 1.01 to 1.42, p=0.04).


CONCLUSIONS
A regimen of three monthly IVB injections yielded effective and sustained results in the treatment of mCNV at 3 years of follow-up. Initial BCVA and age were the factors that correlated independently with BCVA outcome.
Department of Ophthalmology, Sapienza University - Umberto I Hospital, 155 Viale del Policlinico, 00161 Rome, Italy. magda.gharbiya@tiscali.it
Magda
M
Gharbiya
Filippo
F
Cruciani
Francesco
F
Parisi
Giovanni
G
Cuozzo
Simona
S
Altimari
Solmaz
S
Abdolrahimzadeh
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab