Ranibizumab: a review of its use in myopic choroidal neovascularization

Ranibizumab (Lucentis®) is the first inhibitor of vascular endothelial growth factor (VEGF)-A licensed for the treatment of visual impairment due to choroidal neovascularization (CNV) secondary to pathologic myopia (i.e. myopic CNV). The drug inhibits biologically active isoforms of VEGF-A and is administered via intravitreal injection, with the number of treatments required depending on disease activity. The clinical benefit of such a ranibizumab regimen in adults with myopic CNV was demonstrated in a randomized, double-masked, active comparator-controlled, phase III trial known as RADIANCE. In this trial, intravitreal ranibizumab was superior to the standard licensed therapy available to these patients thus far, namely intravenous verteporfin plus photodynamic therapy (verteporfin PDT), in improving visual acuity from month 1 through month 3 of treatment, with improvements in some aspects of vision-related function also evident with ranibizumab versus verteporfin PDT at 3 months. Improvements in vision were sustained for up to 12 months in ranibizumab recipients and were mirrored by improvements in anatomic outcomes. Few ranibizumab injections were required over the trial, with more than 60 % of patients not needing to receive the drug from month 6 to 11. Ranibizumab was generally well tolerated in RADIANCE, with few patients experiencing serious ocular or non-ocular adverse events.