Skip to main content

Advertisement

SpringerLink
Log in

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

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

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

Methods

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.

Results

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.

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Xu L, Wang Y, Li Y, Cui T, Li J, Jonas JB. Causes of blindness and visual impairment in urban and rural areas in Beijing: the Beijing Eye Study. Ophthalmology. 2006;113:1134.e1-11.

    PubMed  Google Scholar 

  2. Iwase A, Araie M, Tomidokoro A, Yamamoto T, Shimizu H, Kitazawa Y, et al. Prevalence and causes of low vision and blindness in a Japanese adult population: the Tajimi Study. Ophthalmology. 2006;113:1354–62.

    Article  PubMed  Google Scholar 

  3. Cohen SY, Laroche A, Leguen Y, Soubrane G, Coscas GJ. Etiology of choroidal neovascularization in young patients. Ophthalmology. 1996;103:1241–4.

    Article  CAS  PubMed  Google Scholar 

  4. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355:1419–31.

    Article  CAS  PubMed  Google Scholar 

  5. Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006;355:1432–44.

    Article  CAS  PubMed  Google Scholar 

  6. Mimoun G, Tilleul J, Leys A, Coscas G, Soubrane G, Souied EH. Intravitreal ranibizumab for choroidal neovascularization in angioid streaks. Am J Ophthalmol. 2010;150:692–700.

    Article  CAS  PubMed  Google Scholar 

  7. Heier JS, Brown D, Ciulla T, Abraham P, Bankert JM, Chong S, et al. Ranibizumab for choroidal neovascularization secondary to causes other than age-related macular degeneration: a phase I clinical trial. Ophthalmology. 2011;118:111–8.

    Article  PubMed  Google Scholar 

  8. Gupta B, Elagouz M, Sivaprasad S. Intravitreal bevacizumab for choroidalneovascularisation secondary to causes other than age-related macular degeneration. Eye (Lond). 2010;24:203–13.

    Article  CAS  Google Scholar 

  9. Wang E, Chen Y. Intravitreal anti-vascular endothelial growth factor for choroidal neovascularization secondary to pathologic myopia: systematic review and meta-analysis. Retina. 2013;33:1375–92.

    Article  CAS  PubMed  Google Scholar 

  10. Fung AE, Lalwani GA, Rosenfeld PJ, Dubovy SR, Michels S, Feuer WJ, et al. An optical coherence tomography-guided, variable dosing regimen with intravitrealranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol. 2007;143:566–83.

    Article  CAS  PubMed  Google Scholar 

  11. Querques G, Azrya S, Martinelli D, Berboucha E, Feldman A, Pece A, et al. Ranibizumab for exudative age-related macular degeneration: 24-month outcomes from a single-centre institutional setting. Br J Ophthalmol. 2010;94:292–6.

    Article  PubMed  Google Scholar 

  12. Rothenbuehler SP, Waeber D, Brinkmann CK, Wolf S, Wolf-Schnurrbusch U. Effects of ranibizumab in patients with subfoveal choroidal neovascularization attributable to age-related macular degeneration. Am J Ophthalmol. 2009;147:831–7.

    Article  CAS  PubMed  Google Scholar 

  13. Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group, Martin DF, Maguire MG, Fine SL, Ying GS, Jaffe GJ, et al. Ranibizumab and bevacizumab for treatment of neovascular age- related macular degeneration: two-year results. Ophthalmology. 2012;119:1388–98.

    Article  PubMed Central  PubMed  Google Scholar 

  14. IVAN Study Investigators, Chakravarthy U, Harding SP, Rogers CA, Downes SM, Lotery AJ, et al. Ranibizumab versus bevacizumab to treat neovascular age-related macular degeneration: one-year findings from the IVAN randomized trial. Ophthalmology. 2012;119:1399–411.

    Article  PubMed  Google Scholar 

  15. Cohen SY, Dubois L, Tadayoni R, Fajnkuchen F, Nghiem-Buffet S, Delahaye-Mazza C, et al. Results of one-year’s treatment with ranibizumab for exudative age-related macular degeneration in a clinical setting. Am J Ophthalmol. 2009;148:409–13.

    Article  CAS  PubMed  Google Scholar 

  16. Bandukwala T, Muni RH, Schwartz C, Eng KT, Kertes PJ. Effectiveness of intravitreal ranibizumab for the treatment of neovascular age-related macular degeneration in a Canadian retina practice: a retrospective review. Can J Ophthalmol. 2010;45:590–5.

    Article  PubMed  Google Scholar 

  17. Rotsos T, Patel PJ, Chen FK, Tufail A. Initial clinical experience of ranibizumab therapy for neovascular age-related macular degeneration. Clin Ophthalmol. 2010;10:1271–5.

    Article  Google Scholar 

  18. Bloch SB, la Cour M, Sander B, Hansen LK, Fuchs J, Lund-Andersen H, et al. Predictors of 1-year visual outcome in neovascular age-related macular degeneration following intravitreal ranibizumab treatment. Acta Ophthalmol. 2013;91:42–7.

    Article  CAS  PubMed  Google Scholar 

  19. Rofagha S, Bhisitkul RB, Boyer DS, Sadda SR, Zhang K, SEVEN-UP Study Group. Seven-year outcomes in ranibizumab-treated patients in ANCHOR, MARINA, and HORIZON: a multicenter cohort study (SEVEN-UP). Ophthalmology. 2013;120:2292–9.

    Article  PubMed  Google Scholar 

  20. Blinder KJ, Blumenkranz MS, Bressler NM, Bressler SB, Donato G, Lewis H, et al. Verteporfin therapy of subfoveal choroidal neovascularization in pathologic myopia: 2-year results of a randomized clinical trial: VIP report no. 3. Ophthalmology. 2003;110:667–73.

    Article  PubMed  Google Scholar 

  21. Verteporfin in Photodynamic Therapy Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in pathologic myopia with verteporfin. 1-year results of a randomized clinical trial: VIP report no. 1. Ophthalmology. 2001;108:841–52.

    Article  Google Scholar 

  22. Cohen SY. Anti-VEGF drugs as the 2009 first-line therapy for choroidal neovascularization in pathologic myopia. Retina. 2009;29:1062–6.

    Article  PubMed  Google Scholar 

  23. Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens C. Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology. 1984;91:1573–81.

    Article  CAS  PubMed  Google Scholar 

  24. Iacono P, Parodi MB, Papayannis A, Kontadakis S, Sheth S, Cascavilla ML, et al. Intravitreal ranibizumab versus bevacizumab for treatment of myopic choroidal neovascularization. Retina. 2012;32:1539–46.

    Article  CAS  PubMed  Google Scholar 

  25. Iacono P, Parodi MB, Papayannis A, Kontadakis S, Sheth S, Bandello F. Intravitreal bevacizumab therapy on an as-per-needed basis in subfoveal choroidal neovascularization secondary to pathological myopia: 2-year outcomes of a prospective case series. Retina. 2011;31:1841–7.

    Article  CAS  PubMed  Google Scholar 

  26. Oishi A, Yamashiro K, Tsujikawa A, Ooto S, Tamura H, Nakata I, et al. Long-term effect of intravitreal injection of anti-VEGF agent for visual acuity and chorioretinal atrophy progression in myopic choroidal neovascularization. Graefes Arch ClinExpOphthalmol. 2013;251:1–7.

    Article  CAS  Google Scholar 

  27. Peiretti E, Vinci M, Fossarello M. Intravitreal bevacizumab as a treatment for choroidalneovascularisation secondary to myopia: 4-year study results. Can J Ophthalmol. 2012;47:28–33.

    Article  PubMed  Google Scholar 

  28. Lai TY, Luk FO, Lee GK, Lam DS. Long-term outcome of intravitreal anti-vascular endothelial growth factor therapy with bevacizumab or ranibizumab as primary treatment for subfoveal myopic choroidal neovascularization. Eye (Lond). 2012;26:1004–11.

    Article  CAS  Google Scholar 

  29. Kang HM, Koh HJ. Ocular risk factors for recurrence of myopic choroidal neovascularization: long-term follow-up study. Retina. 2013;33:1613–22.

    Article  PubMed  Google Scholar 

  30. Franqueira N, Cachulo ML, Pires I, Fonseca P, Marques I, Figueira J, et al. Long-term follow-up of myopic choroidal neovascularization treated with ranibizumab. Ophthalmologica. 2012;227:39–44.

    Article  CAS  PubMed  Google Scholar 

  31. Yang HS, Kim JG, Kim JT, Joe SG. Prognostic factors of eyes with naïve subfoveal myopic choroidal neovascularization after intravitreal bevacizumab. Am J Ophthalmol. 2013;156:1201–21.

    Article  CAS  PubMed  Google Scholar 

  32. Ruiz-Moreno JM, Arias L, Montero JA, Carneiro A, Silva R. Intravitreal anti-VEGF therapy for choroidal neovascularisation secondary to pathological myopia: 4-year outcome. Br J Ophthalmol. 2013;97:1447–50.

    Article  PubMed  Google Scholar 

  33. Wolf S, Balciuniene VJ, Laganovska G, Menchini U, Ohno-Matsui K, Sharma T, et al. RADIANCE: a randomized controlled study of ranibizumab in patients with choroidal neovascularization secondary to pathologic myopia. Ophthalmology. 2014;121:682–92.

    Article  PubMed  Google Scholar 

  34. Tufail A, Narendran N, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, et al. Ranibizumab in myopic choroidal neovascularization: the 12-month results from the REPAIR study. Ophthalmology. 2013;120:1944–5.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by an unrestricted grant from CIL-ASSOC, Association for Research and Education, Paris, France.

Conflicts of interest

S. Y. Cohen, Board membership (Allergan, Bayer, Novartis), Consultant fees (Allergan, Bayer, Bausch and Lomb, Novartis, Thea); S. Nghiem-Buffet, Board membership (Allergan, Bayer, Novartis), Consultant fee (Novartis); T. Grenet, Board membership (Allergan, Novartis); L. Dubois, None; S. Ayrault, None; F. Fajnkuchen, Board membership (Allergan, Novartis), Consultant fee (Bayer); C. Delahaye-Mazza, None; G. Quentel, Board membership (Novartis), Consultant fee (Novartis); and R. Tadayoni, Board membership (Alcon, Novartis, Allergan, Bausch & Lomb, Pfizer, Alimera, Bayer, FCI-Zeiss), Consultant fees (Allergan, DORC, Alcon, Novartis, Takeda, Bausch & Lomb, FCI-Zeiss).

Author information

Authors and Affiliations

  1. Centre Ophtalmologique d’Imagerie et de Laser, 11 Rue Antoine Bourdelle, Paris, 75015, France

    Salomon Y. Cohen, Sylvia Nghiem-Buffet, Typhaine Grenet, Lise Dubois, Sandrine Ayrault, Franck Fajnkuchen, Corinne Delahaye-Mazza & Gabriel Quentel

  2. Department of Ophthalmology, Hôpital Intercommunal and University Paris Est Créteil, Créteil, France

    Salomon Y. Cohen

  3. Department of Ophthalmology, Hôpital Lariboisière, University Paris Diderot, Sorbonne Paris Cité, APHP, Paris, France

    Ramin Tadayoni

Authors
  1. Salomon Y. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sylvia Nghiem-Buffet
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Typhaine Grenet
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lise Dubois
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sandrine Ayrault
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Franck Fajnkuchen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Corinne Delahaye-Mazza
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gabriel Quentel
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ramin Tadayoni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Salomon Y. Cohen.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cohen, S.Y., Nghiem-Buffet, S., Grenet, T. et al. Long-term variable outcome of myopic choroidal neovascularization treated with ranibizumab. Jpn J Ophthalmol 59, 36–42 (2015). https://doi.org/10.1007/s10384-014-0363-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-014-0363-z

Keywords

Search

Navigation