Intravitreal bevacizumab for choroidal neovascularization due to pathologic myopia: long-term outcomes

To report the long-term results of anti-vascular endothelial growth factor (VEGF) therapy for choroidal neovascularization (CNV) secondary to pathological myopia (PM).

Prospective interventional study with extension phase. Eyes affected by CNV due to PM included. All patients received an intravitreal bevacizumab injection (1.25 mg/0.05 ml) at baseline. Re-treatment was considered at each follow-up visit.

The study included 101 consecutive eyes of 86 patients. All patients reached 24 months of follow-up. After 24 months, mean best-corrected visual acuity (BCVA) improvement was -0.13 (95 % CI: -0.2; -0.05) logMAR (p < 0.001) and central retinal thickness (CRT) decreased on average by 67 (95 % CI: 27; 102) μm (p < 0.01). The chorioretinal atrophy (CRA) area increased significantly after 2 years of follow-up (+7.82 mm(2), p < 0.0001). Patients received 4.1 treatments, on average. Thirty-two eyes were included in the extension phase (from 24 to 60 months of follow-up). Visual acuity improved on average by -0.05 (95 % CI: -0.2; 0.1) logMAR (p > 0.05) compared to baseline. Mean reduction in CRT was 102 (95 % CI: 64;141) μm (p < 0.01). The CRA area enlarged significantly after 5 years of follow-up (+14.15 mm(2), p < 0.0001). Patients received a mean of 6.7 treatments in 60 months.

An individualized regimen with intravitreal bevacizumab to treat CNV secondary to PM resulted in BCVA improvement and CRT decrease at 2 and 5 years. The main visual benefit was obtained between month 3 and month 24. A gradual loss of the initial BCVA gain was observed starting from month 30 to month 60 due to progression of CRA.