Anti-VEGF Agents Show Improvement in Treatment of Myopic Choroidal Neovascularization

Among patients with myopic choroidal neovascularization (CNV), the use of either of the 2 antivascular endothelial growth factor (VEGF) agents, ranibizumab or bevacizumab, led to functional and anatomical visual improvement, according to results of a recent study [BMC Ophthalmology. 2014; DOI:10.1186/1471-2415-14-69].

Anti-VEGF agents are changing how various retinal diseases are treated, largely due to other therapies not proving successful in the long-term. Without treatment, the prognosis for myopic CNV is poor. Few studies, however, have directly compared ranibizumab and bevacizumab. Tae Wan Kim, MD, department of ophthalmology, Seoul National University College of Medicine, Seoul, Korea, and colleagues conducted a retrospective, multicenter study to compare the functional and anatomical treatment effectiveness of the 2 agents at 12-month follow up.

A total of 66 eyes of 64 previously untreated patients recently diagnosed with myopic CNV between 2007 and 2009 were included in the analysis and were retrospectively chart reviewed in 2010. All patients underwent thorough ophthalmic examination and best-corrected visual acuity (BCVA) was measured. The primary outcome measures were changes in BCVA from baseline to 1, 2, 3, 6, and 12 months posttreatment and the decreased rate of central foveal thickness (CFT) from baseline to 3, 6, and 12 months after treatment.

The benefits and risks of ranibizumab and bevacizumab were explained to the patients, after which they were able to select either agent. Treatment was administered via intravitreal injection for a total dose equaling 1.25 mg bevacizumab or 0.5 mg ranibizumab. Patients were followed up at 4-week intervals after the first injection, during which BCVA, ophthalmic examination, fluorescein angiography, and optical coherence tomography were performed. Additional injections were given as necessary, and when the lesion disappeared; follow-up increased to 2 to 3 months without treatment, continuing for at least 12 months from the first visit.

Results showed that all patients experienced statistically significant improvement in logarithm of the minimum angle of resolution BCVA (P<.05). No statistically significant differences were seen between the 2 treatment groups. The researchers found CFT decreased by 20.21%, 19.58%, and 22.43% at 3, 6, and 12 months, respectively, among 17 eyes in the ranibizumab group, a statistically significant difference between pre- and posttreatment (all P<.05).

Results from 6-month follow-up also showed BCVA improved by ≥2 lines in 18 of 23 eyes (78%) in the ranibizumab group and 27 of 43 eyes (63%) in the bevacizumab group (P=.24). By 12 months after treatment, BCVA improved by ≥2 lines in 17 of 23 eyes (74%) in the ranibizumab group and 27 of 43 eyes (63%) in the bevacizumab group (P=.99).