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Intravitreal anti-VEGF therapy for choroidal neovascularisation secondary to pathological myopia: 4-year outcome
  1. Jose M Ruiz-Moreno1,2,
  2. Luis Arias3,
  3. Javier A Montero4,5,
  4. Angela Carneiro6,
  5. Rufino Silva7
  1. 1Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain
  2. 2Vitreo-Retinal Unit, Alicante Institute of Ophthalmology, VISSUM, Alicante, Spain
  3. 3Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain
  4. 4Ophthalmology Unit, Pío del Río Hortega University Hospital, Valladolid, Spain
  5. 5Oftalvist, Retina Unit, Madrid, Spain
  6. 6Department of Ophthalmology, Hospital São João, Porto, Portugal
  7. 7Department of Ophthalmology, University Hospital of Coimbra, Coimbra, Portugal
  1. Correspondence to Professor Jose M Ruiz-Moreno, Departamento de Ciencias Médicas, Facultad de Medicina, Avda de Almansa, 14., Albacete 02006, Spain; josemaria.ruiz{at}


Objective To report the visual outcome after 4-year follow-up in a series of highly myopic eyes with choroidal neovascularisation (CNV) treated with antivascular endothelial growth factor (anti-VEGF) drugs.

Methods A retrospective, non-randomised, multicentre, consecutive, interventional case series study was performed. 92 highly myopic eyes with subfoveal CNV were treated with intravitreal injection (IVI) of anti-VEGF. The initial protocol (1 vs 3 injections) was dictated by surgeons’ preferences and followed by an as-needed monthly regime. Best-corrected visual acuity (BCVA) was evaluated at baseline and then monthly. The primary aim was to analyse BCVA changes. The effect of age, spherical equivalent (SE) and treating drug were evaluated as secondary objectives.

Results The mean age of the patients was 57 years (SD 14, range 30–93). The mean number of letters read was 46.1 (SD 16.8, range 5–70) at baseline, 55.5 (SD 18.6, range 10–85) at 12 months, 50.1 (SD 20.1, range 5–82) at 24 months, 54.2 (SD 21.9, range 2–85) at 36 months and 53.1 (SD 22.5, range 1–83) at 48 months (p=0.000, initial vs 12, 24 and 36 months; p=0.01 initial vs 48 months; Student t test for paired data). The mean total number of IVI was 4.9 (SD 5.4, range 1–29). SE and treating drug had no influence on the final visual outcome and number of injections required.

Conclusions Intravitreal bevacizumab and ranibizumab are effective therapies and show similar clinical effects in highly myopic CNV. Visual acuity gain is maintained at 4-year follow-up.

  • Angiogenesis
  • Drugs
  • Macula
  • Retina

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