Background:
To report our functional results of efficacy of intravitreal ranibizumab (IVR) for submacular choroidal neovessels (CNV) in high myopia, and to compare the role of optical coherence tomography (OCT), fluorescein angiography (FA) and visual acuity changes in the treatment decision prior to each injection.
Patients and methods:
This is a retrospective study performed in Jules Gonin Eye Hospital. It included all patients with myopic CNV treated with IVR injections with a minimal follow-up of 24 months. After an induction dosing from 1 to 3 injections, the follow-up was based on a PRN regimen. Ophthalmic evaluation, best corrected visual acuity (BCVA), and OCT were done at each visit, and FA at baseline and if neovascular activity was suspected. Retreatment criteria included metamorphopsia, visual loss of ≥5 ETDRS letters, any fluid on OCT and/or leakage on FA.
Results:
24 eyes were included in the study. Mean follow-up was 49 months. Mean BCVA improved significantly from 62.8 ±13.8 letters at baseline to 72.8 ±12.9 letters at last follow-up visit (p=0.001). The mean number of injections was 2.2 in the first year and below 1 for the following years. The sensitivity of FA, SD OCT, and BCVA loss ≥ 5 letters were 62.6%, 51.4%, and 40% respectively. The FA showed significant higher sensitivity in treatment decision than OCT (p=0.007).
Conclusion:
Our study showed that IVR provides a significant long term visual benefit in myopic CNV with a small number of injections. FA has a preponderant role in the treatment decision of active myopic CNV.
PRECIS
Our study showed long term efficacy of ranibizumab in the treatment of myopic CNV. We studied also the contribution of different modalities (OCT, FA and BCVA loss) in the retreatment decision.