Vascular remodeling of choroidal neovascularization in older myopic patients treated with ranibizumab
To investigate morphological changes in myopic choroidal neovascularization (mCNV) using optical coherence tomography-angiography (OCT-A) after treatment with ranibizumab.
Retrospective analysis of consecutive patients over a 24-month period. All treatment-naïve mCNV were imaged at baseline with color pictures, spectral-domain OCT and OCT-A, and fluorescein angiography in selected cases. CNV morphology was classified at baseline and at 6 months. The CNV lesion surface was also compared.
Twenty-nine patients with a mean age of 70.3 ± 10.1 years were included. They received a mean number of 2.65 injections over 6 months. Best-corrected visual acuity improved from 62.2 to 68.5 letters (p = 0.004), with regression of exudation in 24 eyes (82.7%). Baseline CNV was classified into tree-in-bud (16 eyes), medusa (9 eyes), or sea-fan (4 eyes) pattern. At 6 months, no abnormal blood flow was observed in CNV in 13 eyes. Eyes with complete regression or evolution towards an indistinct pattern showed more often a complete regression of exudation than eyes with unchanged pattern (p = 0.007). The mean CNV surface significantly decreased from 0.19 to 0.08 mm2 (p < 0.0001).
An unchanged pattern was more often associated with exudation persistence, while a complete regression or evolution towards indistinct pattern was always associated with vascular inactivity. However, variable changes in mCNV were observed after anti-VEGF. Thus, OCT-A could be more useful in the diagnosis than in the follow-up of mCNV.
KeywordsMyopia Choroidal neovascularization Anti-VEGF Ranibizumab OCT-angiography
Compliance with ethical standards
Conflict of interest
Salomon Y. Cohen is a consultant for Allergan, Bayer, Novartis, Roche, Thea, and Tilak. Sandrine Tabary is a consultant for Bayer. Ala El Amen declares that he has no conflict of interest. Sarah Mrejen is a consultant for Allergan, Bayer, and Novartis. Gabriel Quentel is a consultant for Novartis. Audrey Giocanti-Auregan is a consultant for Allergan, Bayer, Novartis, and Optos Plc.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Agreement to perform the study was given by the Ethical Committee of the Federation France Macula.
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