Retinoschisis and intravitreal ranibizumab treatment for myopic choroidal neovascularization

Intravitreal ranibizumab injection is effecitve on treating myopic CNVs, but it could be a risk factor for developing more severe retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane. This study aimed to explore the incidence and features of retinoschisis after intravitreal ranibizumab injection for myopic choroidal neovascularization.

Eighty-three eyes of 81 patients with choroidal neovascularization secondary to pathologic myopia were treated with intravitreal ranibizumab injection. The best corrected visual acuity and optical coherence tomography (OCT) images were recorded at baseline and every month thereafter. Central retina thickness and maximal retina thickness were measured. The subjects were divided into three groups. Eleven eyes that had retinoschisis and epiretinal membrane were in group 1, six eyes that had simple epiretinal membrane were in group 2, and 66 eyes that had neither retinoschisis nor epiretinal membrane were in group 3. Six contralateral eyes in group 1 which had retinoschisis and epiretinal membrane but were not treated with intravitreal ranibizumab injection were set as the control group.

Seven of the 11 eyes in group 1 developed more severe retinoschisis, the mean maximal retinal thickness increased from (380.28 ± 90.13) to (467.00 ± 70.20) µm (P < 0.05). The retinoschisis of all 6 eyes of the control group did not aggravate. Compared with the control group, the aggravation ratio of retinoschisis increased significantly (P < 0.05). No new onset of retinoschisis took place in group 2 and group 3.

Intravitreal ranibizumab injection may be a risk factor for aggravation of retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane.