Long-term results of intravitreal bevacizumab for choroidal neovascularisation in pathological myopia

To evaluate the long-term results and prognostic factors of intravitreal bevacizumab (IVB) for myopic choroidal neovascularisation (mCNV).

Thirty-two eyes of 30 patients with mCNV were included in a prospective case series. Treatment consisted of three monthly 1.25 mg IVB injections. Best corrected visual acuity (BCVA) and CNV area were compared before and after treatment. Prognostic factors included in the regression analyses were age, axial length, baseline BCVA, pretreatment CNV area, CNV location and peripapillary atrophy area.

Results were evaluated at 2 years for 32 eyes and at 3 years for 27 eyes. Mean (± SD) baseline BCVA had improved significantly from 30.1 (± 15.6) letters to 45.4 (± 13.0) letters at 3 years (p<0.0001), with a better outcome in eyes with juxtafoveal CNV (40.4 ± 13.5 vs. 54.0 ± 5.8, p=0.001). Baseline BCVA correlated positively with final BCVA (β= 0.560, p=0.001), while age showed a negative correlation (β= -0.399, p=0.01). CNV area decreased from 0.63 (± 0.71) mm(2) at baseline to 0.40 (± 0.57) mm(2) at 3 years (p<0.0001). Peripapillary atrophy area was the only significant contributing determinant for re-treatment (OR 1.20, 95% CI 1.01 to 1.42, p=0.04).

A regimen of three monthly IVB injections yielded effective and sustained results in the treatment of mCNV at 3 years of follow-up. Initial BCVA and age were the factors that correlated independently with BCVA outcome.