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Myopic choroidal neovascularization treated by intravitreal bevacizumab: comparison of two different initial doses

  • Medical Ophthalmology
  • Published:
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Abstract

Background

Myopic maculopathy is the leading cause of subfoveal choroidal neovascularization (CNV) in patients under 50 years of age. New antiangiogenic drugs are being used off-label with varied therapeutic schedules to treat CNV. The aim of this study is to report the anatomical and visual outcomes of myopic choroidal neovascularization (CNV) treated by two different schedules with intravitreal bevacizumab.

Methods

Prospective, comparative, consecutive, non-randomized, multicentric, interventional pilot study. Two groups of highly myopic patients with subfoveal and juxtafoveal CNV were treated by monthly intravitreal injections with 1.25 mg bevacizumab. Group 1 comprised 19 eyes treated by three consecutive monthly intravitreal injections. Group 2 comprised 20 eyes treated by one single intravitreal injection. Patients were evaluated for best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) at baseline and then monthly. Fluorescein angiography was performed at baseline and when CNV activity was suspected. Further intravitreal injections were performed if CNV activity was detected.

Results

Both groups were matched for age, spherical equivalent, LogMAR BCVA, and central foveal thickness (CFT) as determined by OCT at baseline and number of eyes with previous PDT treatment. The average number of letters gained was 6.3 in group 1 vs 7.2 in group 2 (p = 0.001 and 0.09 respectively, Student's t-test for paired data). Changes in OCT were not significant for either group by the end of follow-up. The mean number injections performed was 3.2 in group 1 vs 1.7 in group 2 (p = 0.00, Mann–Whitney test). Four recurrences (four eyes) occurred in group 1 vs 15 (seven eyes) in group 2 (p = 0.001; Fisher's exact test).

Conclusions

Both schedules achieved similar results improving BCVA, though the second group required a lower number of injections, showing a higher rate of recurrences during the first year.

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Acknowledgments

This study has been supported in part by a grant of the Spanish Ministry of Health, Instituto de Salud Carlos III, Red Temática de Investigación Cooperativa en Salud "Patología ocular del envejecimiento, calidad visual y calidad de vida" (RD07/0062/0019).

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Authors and Affiliations

  1. Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain

    Jose M. Ruiz-Moreno

  2. Alicante Institute of Ophthalmology, VISSUM, Vitreo-Retinal Unit, Alicante, Spain

    Jose M. Ruiz-Moreno, Javier A. Montero & Pedro Amat-Peral

  3. Pio del Rio Hortega Hospital, University of Valladolid, Valladolid, Spain

    Javier A. Montero

  4. Departamento de Ciencias Médicas, Facultad de Medicina, Avda de Almansa, 14, 02006, Albacete, Spain

    Jose M. Ruiz-Moreno

Authors
  1. Jose M. Ruiz-Moreno
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  2. Javier A. Montero
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  3. Pedro Amat-Peral
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Corresponding author

Correspondence to Jose M. Ruiz-Moreno.

Additional information

The authors have full control of all primary data, and they agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review their data if requested.

The design of this study was reviewed and approved by the clinical ethics committee at Vissum Ophthalmological Institute of Alicante.

Written informed consent and individualized approval from the National Ministry of Health was obtained prior to the procedure.

This study has been performed in accordance with the ethical standards of the 1964 Declaration of Helsinki, and data gathering was performed after obtaining written informed consent. Patients were informed about the off-label situation of this therapy and women of child bearing age were also informed about the possible risks of pregnancy and in utero exposition.

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Ruiz-Moreno, J.M., Montero, J.A. & Amat-Peral, P. Myopic choroidal neovascularization treated by intravitreal bevacizumab: comparison of two different initial doses. Graefes Arch Clin Exp Ophthalmol 249, 595–599 (2011). https://doi.org/10.1007/s00417-010-1599-z

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  • DOI: https://doi.org/10.1007/s00417-010-1599-z

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