Abstract
Purpose
To determine the factors significantly associated with an enlargement of the area of a chorioretinal atrophy (ChRA) after intravitreal bevacizumab (IVB) to treat myopic choroidal neovascularization (mCNV).
Methods
The medical charts of 27 eyes with a mCNV that had received IVB were reviewed. The ophthalmic examinations included measurements of the best-corrected visual acuity, visual fields with the Humphrey 10-2 Field Analyzer, fluorescein angiography, and indocyanine green angiography. The area of the mCNV and the chorioretinal atrophy (ChRA) were measured on the FA images.
Results
Eyes with an enlargement of the ChRA had significantly larger mCNVs at the baseline, a greater reduction in the size of the mCNV, a higher incidence of subretinal hemorrhage, longer duration of follow-up, received more injections of IVB, and had a greater decrease of retinal sensitivity (P ≤ 0.041). Multiple regression analyses showed that the factors most significantly associated with an enlargement of the ChRA were the CNV size at baseline, the number of IVB injections, and the duration of the follow-up period (P < 0.0001).
Conclusions
Our findings showed that eyes with a larger CNV at the baseline and longer follow-up period had a greater risk of developing a ChRA like non-treatment, even if IVB treatment was performed for mCNV.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Avery RL, Pieramici DJ, Rabena MD, Castellarin AA, Nasir MA, Giust MJ (2006) Intravitrealbevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmology 113:363–372
Hayashi K, Ohno-Matsui K, Teramukai S, Shimada N, Moriyama M, Hara W, Yoshida T, Tokoro T, Mochizuki M (2008) Photodynamic therapy with verteporfin for choroidal neovascularization of pathologic myopia in Japanese patients: comparison with nontreated controls. Am J Ophthalmol 145:518–526
Hayashi K, Ohno-Matsui K, Teramukai S, Shimada N, Moriyama M, Hayashi W, Yoshida T, Tokoro T, Mochizuki M (2009) Comparison of visual outcome and regression pattern of myopic choroidal neovascularization after intravitreal bevacizumab or after photodynamic therapy. Am J Ophthalmol 148:396–408
Kojima A, Ohno-Matsui K, Teramukai S, Yoshida T, Ishihara Y, Kobayashi K, Shimada N, Yasuzumi K, Futagami S, Tokoro T, Mochizuki M (2004) Factors associated with the development of chorioretinal atrophy around choroidal neovascularization in pathologic myopia. Graefes Arch Clin Exp Ophthalmol 242:114–119
Tokoro T (1998) Types of fundus changes in the posterior pole. In: Tokoro T (ed) Atlas of posterior fundus changes in pathological myopia. Springer, Tokyo, pp 5–22
Yoshida T, Ohno-Matsui K, Yasuzumi K, Kojima A, Shimada N, Futagami S, Tokoro T, Mochizuki M (2003) Myopic choroidal neovascularization: a 10-year follow-up. Ophthalmology 110:1297–1305
Hewitt AT, Adler R (1989) The retinal pigment epithelium and interphotoreceptor matrix: structure and specialized functions. In: Ryan SJ, ed Retina. St. Louis:Mosby-year book Inc, pp 57–64
Korte GE, Reppucci V, Henkind P (1984) RPE destruction causes choriocapillary atrophy. Invest Ophthalmol Vis Sci 25:1135–1145
Leonard DS, Zhang XG, Panozzo G, Sugino IK, Zarbin MA (1997) Clinicopathologic correlation of localized retinal pigment epithelium debridement. Invest Ophthalmol Vis Sci 38:1094–1109
Ivert L, Kong J, Gouras P (2003) Changes in the choroidal circulation of rabbit following RPE removal. Graefes Arch Clin Exp Ophthalmol 241:656–666
Uemoto R, Yamamoto S, Takeuchi S (2005) Changes in retinal pigment epithelium after indocyanine green-assisted internal limiting lamina peeling during macular hole surgery. Am J Ophthalmol 140:752–755
Saka N, Ohno-Matsui K, Shimada N, Sueyoshi S, Nagaoka N, Hayashi W, Hayashi K, Moriyama M, Kojima A, Yasuzumi K, Yoshida T, Tokoro T, Mochizuki M (2010) Long-term changes in axial length in adult eyes with pathologic myopia. Am J Ophthalmol 150:562–568
Hochman MA, Seery CM, Zarbin MA (2010) Surv OphthalmolPathophysiology and management of subretinal hemorrhage. Surv Ophthalmol 42:195–213
Gillies A, Lahav M (1983) Absorption of retinal and subretinal hemorrhages. Ann Ophthalmol 15:1068–1074
Tezel TH, Del Priore LV, Flowers BE, Grosof DH, Benenson IL, Zamora RL, Kaplan HJ (1996) Correlation between scanning laser ophthalmoscope microperimetry and anatomic abnormalities in patients with subfoveal neovascularization. Ophthalmology 103:1829–1836
Acknowledgements
The authors thank Professor Duco Hamasaki, Bascom Palmer Eye Institute, University of Miami, School of Medicine, Miami, Florida, for his critical discussion and final manuscript revision.
Proprietary interest
None of the authors or their family members has any proprietary or financial interest in the instruments used in this study. This study has not been published or presented at any meeting.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Uemoto, R., Nakasato-Sonn, H., Kawagoe, T. et al. Factors associated with enlargement of chorioretinal atrophy after intravitreal bevacizumab for myopic choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol 250, 989–997 (2012). https://doi.org/10.1007/s00417-011-1921-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-011-1921-4