Four-year outcomes after intravitreal aflibercept for macular neovascularization in patients with pathologic myopia.

Abstract

The natural course of the visual acuity in eyes with myopic macular neovascularization (myopic MNV) is poor. Intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents have demonstrated safety and efficacy in the short-term for managing myopic MNV. The purpose of this study was to determine the 4-year outcomes of intravitreal aflibercept (IVA) injections. A retrospective monocentric study including 49 eyes of 48 patients diagnosed with myopic MNV. These patients underwent treatment with IVA using the pro re nata (PRN) regimen after the first injection. The minimum follow-up duration was 4 years. The patients had an average age of 63.8 years and an average axial length of 29.7 mm. The mean number of IVA injections was 1.6, and 30 eyes (61.2%) had a single injection. At the baseline and at 1-, 2-, 3-, and 4-years, the mean best-corrected visual acuities (BCVAs) were 20/45, 20/41, 20/43, 20/51, and 20/53, respectively. The differences in the BCVA at the different times from that at the baseline were not significant. IVA therapy with the PRN regimen provides a 4-year visual benefit in eyes with myopic MNV, and it is better than the reported natural course in maintaining the BCVA.