Long-term variable outcome of myopic choroidal neovascularization treated with ranibizumab

The purpose was to evaluate the long-term efficacy of ranibizumab for the treatment of myopic choroidal neovascularization (CNV) in a clinical setting.

This was a retrospective, monocentric, noncomparative analysis of 51 eyes of 51 patients with naïve juxtafoveal or subfoveal myopic CNV treated with intravitreal ranibizumab (IVR) on a pro re nata basis for at least 24 months. The patients' demographic data were recorded, including the best-corrected visual acuity (BCVA) measured with an ETDRS chart, location of the CNV, grade of myopic changes, central foveal thickness (CFT), and number of administered IVR. Outcome measures were to determine the changes in BCVA, identify the factors influencing the visual outcome, compare the best visual gain obtained for each treated eye with the final visual gain, and identify the cause of the relative decline in the visual acuity, when present.

BCVA improved from 58.7 ± 19.0 letters at baseline to 66.3 ± 16.2 letters at the final visit (P = 0.001; mean visual gain: +7.6 ± 15.6 letters). Multivariate analysis did not identify any correlation between the visual gain and age, sex, grade of myopic fundus changes, CNV location, or initial protocol. The mean IVR number was 3.5 ± 2.8 injections (range 1-12; median 3) for a mean follow-up of 39.3 ± 11.3 months (range 24-69). Twenty-one eyes experienced a relative decline in BCVA during the follow-up, which was attributable in 16 cases to myopic atrophic changes.

Intravitreal ranibizumab resulted in long-term efficacy in the treatment of myopic CNV. However, some eyes may present a long-term relative decline in their initial visual gain.