Myopic macular neovascularization treatment: A 2-year follow-up of a real-life cohort

Evaluating the impact for different number of Anti-vascular endothelial growth Factor (VEGF) injections on macular neovascularization (MNV) secondary to pathological myopia, during a 2-year follow-up period, in relation to visual outcome.

This was a multicenter, retrospective study of patients with myopic MNV (mMNV) for 24 months.

A total of 55 patients with mMNV, with a mean age of 65.7 ± 14.5 years, met the inclusion criteria. The mean number of injections was significantly higher during the first year of follow-up with 8.78 ± 2.90 within the 1st year versus 3.45 ± 4.40 during the 2nd year (p = 0.037). Visual acuity (VA) remained relatively stable throughout the follow-up (p = 0.902), with most patients maintaining their vision or experiencing a loss of up to 5 Snellen letters. (42 patients, 76.3%, p < 0.001).

During a 24-month period, there was a lack of BCVA improvement, which may be attributed to the PRN injection regimen and the relatively low number of injections administered for mMNV. These findings suggest that mMNV may be undertreated in routine practice, with suboptimal intravitreal injection frequency.

What is known The PRN injection regimen is widely used for treating myopic macular neovascularization (mMNV) due to its less aggressive nature and the potential risks of retinal break, retinal detachment, and other complications in highly myopic eyes. What is new At the 24-month follow-up, patients with mMNV treated with anti-VEGF agents in a PRN regimen showed no significant improvement in BCVA. Myopic MNV may be fallacy thought of as a less aggressive pathology and therefore is undertreated and perhaps may require a much more intensive injection schedule.