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  • Intravitreal bevacizumab monotherapy in myopic choroidal neovascularisation: 5-year outcomes for the PAN-American Collaborative Retina Study Group

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Clinical science
Intravitreal bevacizumab monotherapy in myopic choroidal neovascularisation: 5-year outcomes for the PAN-American Collaborative Retina Study Group
  1. Jay Chhablani1,
  2. Remya Mareen Paulose1,
  3. Andres F Lasave2,
  4. Lihteh Wu3,
  5. Cristian Carpentier4,
  6. Mauricio Maia5,
  7. Silvio Lujan6,
  8. Sergio Rojas7,
  9. Martin Serrano8,
  10. Maria H Berrocal9,
  11. J Fernando Arevalo10
  12. for the Pan-American Collaborative Retina Study Group
  1. 1 LV Prasad Eye Institute, Hyderabad, India
  2. 2 Retina and Vitreous Service, Clínica Privada de Ojos, Mar del Plata, Argentina
  3. 3 Instituto de Cirugia Ocular, San Jose, Costa Rica
  4. 4 Fundacion Oftalmológica Los Andes, Los Andes University, Santiago de Chile, Chile
  5. 5 Retina Division, Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
  6. 6 MACULA D&T Diagnóstico, Tratamiento & Rehabilitación Visual, Lima, Peru
  7. 7 Fundación Hospital Nuestra Señora de la Luz, Mexico City, Mexico
  8. 8 Clinica Oftalmologica Centro Caracas and the Arevalo Coutinho Foundation for Research in Ophthalmology, Caracas, Bolivarian Republic of Venezuela
  9. 9 Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico, USA
  10. 10 Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr J Fernando Arevalo, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Maumenee 708, Baltimore, MD 21287, USA; arevalojf{at}jhmi.edu

Abstract

Purpose To report the long-term anatomical and visual outcomes of intravitreal bevacizumab (IVB) monotherapy in naive choroidal neovascularisation (CNV) caused by myopia.

Methods Retrospective analysis of naive CNV secondary to myopia that underwent antivascular endothelial growth factor monotherapy was performed. Collected data included demographic details, clinical examination details including visual acuity at presentation and follow-up with imaging and treatment details. Main outcome measures were resolution of CNV activity at the last visit. Secondary outcomes included change in visual acuity, number of injections and adverse events.

Results Thirty-three eyes of 31 subjects with a mean age of 51.48±16.4 years were included. The mean follow-up was 66.47 months. 27 eyes had type 2 CNV and the rest seven eyes had type 1 CNV. The mean number of IVB injections per eye was 4.9. Mean visual acuity at baseline reduced from 0.65±0.33 logMAR units (Snellen equivalent=20/89) to 0.73±0.50 logMAR units (20/107) at final follow-up (p=0.003). The mean central macular thickness decreased from 309.31±86 µm at baseline to 267.5±70.89 µm at the last visit (p=0.03). However, visual acuity was maintained (±1 line of baseline) in 13 eyes (39.4%), ≥2 line improvement in nine (27.3%) eyes and more than two lines worsening in 11 eyes (33.3%). Foveal atrophy was observed at baseline and last visit in 6 (12.5%) and 14 (29.1%), respectively (p=0.007). No systemic adverse events were observed.

Conclusion IVB monotherapy is safe and effective for long-term treatment of CNV secondary to myopia in real life.

  • choroidal neovascularization
  • anti-VEGF
  • myopia
  • bevacizumab

https://doi.org/10.1136/bjophthalmol-2017-310411

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    Footnotes

    • Contributors JC and JFA designed the study. LW, CC, MM, SL, SR, MS, MHB, RFL and JFA conducted the study and collected the data. JC, RMP and JFA were involved in the management, analysis and interpretation of the data and preparation of the manuscript. JC, RM, LW, CC, MM, SL, SR, MS, MHB, RFL and JFA did the review and approval of the final manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Institutional ethics committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Collaborators For a complete listing of participating members of PACORES, see online appendix.