Intravitreal aflibercept for myopic choroidal neovascularization.
OBJECTIVE
To assess the use of aflibercept for the treatment of subfoveal myopic choroidal neovascularization (CNV).


METHODS
Thirty-two patients (33 eyes) with myopic subfoveal CNV were consecutively enrolled in this prospective open-label case series. All patients were treated with an off-label 2-mg intravitreal injection of aflibercept. After the first injection, administration of aflibercept followed an "on demand" pro re nata (PRN) regimen. The primary outcome was change in best-corrected visual acuity (BCVA) score after 12 months.


RESULTS
Mean follow-up was 12 months, and the median number of aflibercept injections was 2.0 (range 1-4). Overall, mean BCVA improved from 0.59 ± 0.37 logMAR at baseline to 0.38 ± 0.33 logMAR at 12 months, a change of -0.21 ± 0.23 logMAR (p < 0.0001), and from 70.5 ± 18.5 to 81.1 ± 16.4 letters, a change of 10.6 ± 11.4 (p < 0.0001). Improvements were similar among patients irrespective of previous PDT. The Increase in BCVA was greater in younger patients (aged < 50 years) and those with baseline BCVA of ≤ 75 letters.


CONCLUSIONS
Intravitreal aflibercept in a PRN regimen is effective for the treatment of myopic CNV, with no apparent short-term safety effects. Treated eyes had BCVA gains after 12 months, with a median of two injections.
Unità Operativa di Oftalmologia, Ospedale di Melegnano, Via Pandina 1, 20077, Melegnano, (MI), Italy. pece.retina@mclink.it.
Alfredo
A
Pece
Fondazione Retina 3000, Milan, Italy.
Paolo
P
Milani
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D011446:Prospective Studies; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012029:Refraction, Ocular; D041623:Tomography, Optical Coherence / Q000379:methods; D016896:Treatment Outcome; D014792:Visual Acuity
D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor
Aflibercept; Anti-VEGF therapy; Choroidal neovascularization; Pathological myopia