Top

Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

01-03-2016 | Retinal Disorders

Intravitreal bevacizumab for choroidal neovascularization due to pathologic myopia: long-term outcomes

Authors: Valentina Sarao, Daniele Veritti, Sara Macor, Paolo Lanzetta

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 3/2016

Abstract

Purpose

To report the long-term results of anti-vascular endothelial growth factor (VEGF) therapy for choroidal neovascularization (CNV) secondary to pathological myopia (PM).

Methods

Prospective interventional study with extension phase. Eyes affected by CNV due to PM included. All patients received an intravitreal bevacizumab injection (1.25 mg/0.05 ml) at baseline. Re-treatment was considered at each follow-up visit.

Results

The study included 101 consecutive eyes of 86 patients. All patients reached 24 months of follow-up. After 24 months, mean best-corrected visual acuity (BCVA) improvement was −0.13 (95 % CI: −0.2; −0.05) logMAR (p < 0.001) and central retinal thickness (CRT) decreased on average by 67 (95 % CI: 27; 102) μm (p < 0.01). The chorioretinal atrophy (CRA) area increased significantly after 2 years of follow-up (+7.82 mm², p < 0.0001). Patients received 4.1 treatments, on average. Thirty-two eyes were included in the extension phase (from 24 to 60 months of follow-up). Visual acuity improved on average by −0.05 (95 % CI: −0.2; 0.1) logMAR (p > 0.05) compared to baseline. Mean reduction in CRT was 102 (95 % CI: 64;141) μm (p < 0.01). The CRA area enlarged significantly after 5 years of follow-up (+14.15 mm², p < 0.0001). Patients received a mean of 6.7 treatments in 60 months.

Conclusions

An individualized regimen with intravitreal bevacizumab to treat CNV secondary to PM resulted in BCVA improvement and CRT decrease at 2 and 5 years. The main visual benefit was obtained between month 3 and month 24. A gradual loss of the initial BCVA gain was observed starting from month 30 to month 60 due to progression of CRA.

Yoshida T, Ohno-Matsui K, Yasuzumi K, Kojima A, Shimada N, Futagami S, Tokoro T, Mochizuki M (2003) Myopic choroidal neovascularization: a 10-year follow-up. Ophthalmology 110:1297–1305CrossRefPubMed

Wong TY, Ohno-Matsui K, Leveziel N, Holz FG, Lai TY, Yu HG, Lanzetta P, Chen Y, Tufail A (2014) Myopic choroidal neovascularization: current concepts and update on clinical management. Br J Ophthalmol. doi:10.1136/bjophthalmol-2014-305131 PubMedCentral

Wong TY, Ferreira A, Hughes R, Carter G, Mitchell P (2014) Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review. Am J Ophthalmol 157:9–25CrossRefPubMed

Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL (1984) Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology 91:1573–1581CrossRefPubMed

Pece A, Brancato R, Avanza P, Camesasca F, Galli L (1994) Laser photocoagulation of choroidal neovascularization in pathologic myopia: long-term results. Int Ophthalmol 18:339–344CrossRefPubMed

Virgili G, Menchini F (2005) Laser photocoagulation for choroidal neovascularisation in pathologic myopia. Cochrane Database Syst Rev 4:CD004765PubMed

Verteporfin in Photodynamic Therapy Study Group (2001) Photodynamic therapy of subfoveal choroidal neovascularization in pathologic myopia with verteporfin: 1-year results of a randomized clinical trial-VIP report No. 1. Ophthalmology 108:841–852CrossRef

Blinder KJ, Blumenkranz MS, Bressler NM, Bressler SB, Donato G, Lewis H, Lim JI, Menchini U, Miller JW, Mones JM, Potter MJ, Pournaras C, Reaves A, Rosenfeld P, Schachat AP, Schmidt-Erfurth U, Sickenberg M, Singerman LJ, Slakter JS, Strong HA, Virgili G, Williams GA (2003) Verteporfin therapy of subfoveal choroidal neovascularization in pathologic myopia: 2-year results of a randomized clinical trial-VIP report no. 3. Ophthalmology 110:667–673CrossRefPubMed

Gharbiya M, Giustolisi R, Allievi F, Fantozzi N, Mazzeo L, Scavella V, Gabrieli CB (2010) Choroidal neovascularization in pathologic myopia: intravitreal ranibizumab versus bevacizumab—a randomized controlled trial. Am J Ophthalmol 149:458–464CrossRefPubMed

10.

Baba T, Kubota-Taniai M, Kitahashi M, Okada K, Mitamura Y, Yamamoto S (2010) Two-year comparison of photodynamic therapy and intravitreal bevacizumab for treatment of myopic choroidal neovascularisation. Br J Ophthalmol 94:864–870CrossRefPubMed

11.

Franqueira N, Cachulo ML, Pires I, Fonseca P, Marques I, Figueira J, Silva R (2012) Long-term follow-up of myopic choroidal neovascularization treated with ranibizumab. Ophthalmologica 227:39–44CrossRefPubMed

12.

Lai TY, Luk FO, Lee GK, Lam DS (2012) Long-term outcome of intravitreal anti-vascular endothelial growth factor therapy with bevacizumab or ranibizumab as primary treatment for subfoveal myopic choroidal neovascularization. Eye 26:1004–1011PubMedCentralCrossRefPubMed

13.

Ikuno Y, Ohno-Matsui K, Wong TY, Korobelnik JF, Vitti R, Li T, Stemper B, Asmus F, Zeitz O, Ishibashi T, MYRROR Investigators (2015) Intravitreal Aflibercept Injection in Patients with Myopic Choroidal Neovascularization: The MYRROR Study. Ophthalmology 122:1220-1227

14.

Wolf S, Balciuniene VJ, Laganovska G, Menchini U, Ohno-Matsui K, Sharma T, Wong TY, Silva R, Pilz S, Gekkieva M, RADIANCE Study Group (2014) RADIANCE: a randomized controlled study of ranibizumab in patients with choroidal neovascularization secondary to pathologic myopia. Ophthalmology 121:682–692CrossRefPubMed

15.

Tufail A, Narendran N, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Osoba O, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Andrews C, Brittain C, Osborne A, Yang Y (2013) Ranibizumab in myopic choroidal neovascularization: The 12-month results from the REPAIR study. Ophthalmology 120:1944–1945CrossRefPubMed

16.

Hamelin N, Glacet-Bernard A, Brindeau C, Mimoun G, Coscas G, Soubrane G (2002) Surgical treatment of subfoveal neovascularization in myopia: Macular translocation versus surgical removal. Am J Ophthalmol 133:530–536CrossRefPubMed

17.

Ruiz-Moreno JM, de la Vega C (2001) Surgical removal of subfoveal choroidal neovascularization in highly myopic patients. Br J Ophthalmol 85:1041–1043PubMedCentralCrossRefPubMed

18.

Yamamoto I, Rogers AH, Reichel E, Yates PA, Duker JS (2007) Intravitreal bevacizumab (Avastin) as treatment for subfoveal choroidal neovascularization secondary to pathological myopia. Br J Ophthalmol 91:157–160PubMedCentralCrossRefPubMed

19.

Chan WM, Lai TY, Liu DT, Lam DS (2007) Intravitreal bevacizumab (Avastin) for myopic choroidal neovascularization: six-month results of a prospective pilot study. Ophthalmology 114:2190–2196CrossRefPubMed

20.

Gharbiya M, Allievi F, Mazzeo L, Gabrieli CB (2009) Intravitreal bevacizumab treatment for choroidal neovascularization in pathologic myopia: 12-month results. Am J Ophthalmol 147:84–93CrossRefPubMed

21.

Monés JM, Amselem L, Serrano A, Garcia M, Hijano M (2009) Intravitreal ranibizumab for choroidal neovascularization secondary to pathologic myopia: 12-month results. Eye 23:1275–1280CrossRefPubMed

22.

Silva RM, Ruiz-Moreno JM, Rosa P, Carneiro A, Nascimento J, Rito LF, Cachulo ML, Carvalheira F, Murta JN (2010) Intravitreal ranibizumab for myopic choroidal neovascularization: 12-month results. Retina 30:407–412CrossRefPubMed

23.

Ikuno Y, Nagai Y, Matsuda S, Arisawa A, Sho K, Oshita T, Takahashi K, Uchihori Y, Gomi F (2010) Two-year visual results for older Asian women treated with photodynamic therapy or bevacizumab for myopic choroidal neovascularization. Am J Ophthalmol 149:140–146CrossRefPubMed

24.

Ruiz-Moreno JM, Montero JA (2010) Intravitreal bevacizumab to treat myopic choroidal neovascularization: 2-year outcome. Graefes Arch Clin Exp Ophthalmol 248:937–941CrossRefPubMed

25.

Gharbiya M, Cruciani F, Parisi F, Cuozzo G, Altimari S, Abdolrahimzadeh S (2012) Long-term results of intravitreal bevacizumab for choroidal neovascularisation in pathological myopia. Br J Ophthalmol 96:1068–1072CrossRefPubMed

26.

Iacono P, Parodi MB, Papayannis A, Kontadakis S, Sheth S, Bandello F (2011) Intravitreal bevacizumab therapy on an as-per-needed basis in subfoveal choroidal neovascularization secondary to pathological myopia: 2-year outcomes of a prospective case series. Retina 31:1841–1847CrossRefPubMed

27.

Peiretti E, Vinci M, Fossarello M (2012) Intravitreal bevacizumab as a treatment for choroidal neovascularization secondary to myopia:4-year study results. Can J Ophthalmol 47:28–33CrossRefPubMed

28.

Oishi A, Yamashiro K, Tsujikawa A, Ooto S, Tamura H, Nakata I, Miyake M, Yoshimura N (2013) Long-term effect of intravitreal injection of anti-VEGF agent for visual acuity and chorioretinal atrophy progression in myopic choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol 251:1–7CrossRefPubMed

29.

Yodoi Y, Tsujikawa A, Nakanishi H, Otani A, Tamura H, Ojima Y, Hayashi H, Yoshimura N (2009) Central retinal sensitivity after intravitreal injection of bevacizumab for myopic choroidal neovascularization. Am J Ophthalmol 147:816–824CrossRefPubMed

30.

Uemoto R, Nakasato-Sonn H, Kawagoe T, Akira M, Okada E, Mizuki N (2012) Factors associated with enlargement of chorioretinal atrophy after intravitreal bevacizumab for myopic choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol 250:989–997CrossRefPubMed

31.

Khanifar AA, Lederer DE, Ghodasra JH, Stinnett SS, Lee JJ, Cousins SW, Bearelly S (2012) Comparison of color fundus photographs and fundus autofluorescence images in measuring geographic atrophy area. Retina 32:1884–1891PubMedCentralPubMed

32.

Ruiz-Moreno JM, Montero JA, Amat-Peral P (2011) Myopic choroidal neovascularization treated by intravitreal bevacizumab: comparison of two different initial doses. Graefes Arch Clin Exp Ophthalmol 249:595–599CrossRefPubMed

33.

Ruiz-Moreno JM, Arias L, Montero JA, Carneiro A, Silva R (2013) Intravitreal anti-VEGF therapy for choroidal neovascularisation secondary to pathological myopia: 4-year outcome. Br J Ophthalmol 97:1447–1450CrossRefPubMed

34.

CATT Research Group, Martin DF, Maguire MG, Fine SL, Ying GS, Jaffe GJ, Grunwald JE, Toth C, Redford M, Ferris FL 3rd (2012) Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration. Two years results. Ophthalmology 119:1388–1398CrossRef

Title: Intravitreal bevacizumab for choroidal neovascularization due to pathologic myopia: long-term outcomes
Authors: Valentina Sarao
Daniele Veritti
Sara Macor
Paolo Lanzetta
Publication date: 01-03-2016
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 3/2016
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-015-3076-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intravitreal bevacizumab for choroidal neovascularization due to pathologic myopia: long-term outcomes

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2016

Evaluation of mechanical closure resistance of sutureless vitrectomy sclerotomies after conjunctival cauterization with bipolar diathermy forceps

Prophylactic removal and microbiological evaluation of calcified plaques after pterygium surgery

Ophthalmia neonatorum treatment and prophylaxis: IPOSC global study

Nd:Yag laser goniopuncture for deep sclerectomy: efficacy and outcomes

Outcomes of Descemet membrane endothelial keratoplasty, Descemet stripping automated endothelial keratoplasty and penetrating keratoplasty from a single centre study

Giant premacular bursa: a novel finding of the posterior vitreous in two patients with Stickler syndrome type 1 revealed by swept-source optical coherence tomography