Abstract
The visual outcome of myopic choroidal neovascularization (CNV) after anti-vascular endothelial growth factor (anti-VEGF) therapy varies among individuals. We retrospectively analyzed the data of 24 eyes (24 patients) with treatment-naïve myopic CNV who underwent anti-VEGF monotherapy following a pro-re-nata regimen at the Division of Medical Retina Clinic, Department of Ophthalmology, Keio University Hospital between May 2014 and December 2017. The mean age was 70.6 ± 2.1 years, and 16 (66.7%) patients were female. Overall, the mean best-corrected visual acuity (BCVA) improved (p = 0.034), and the mean height of the hyperreflective material (HRM), involving the CNV lesion recorded by optical coherence tomography, decreased (p < 0.01) 12 months after the initial treatment. Fifteen eyes (62.5%) achieved a BCVA of better than 0.10 in LogMAR at 12 months; they had a better BCVA (p = 0.015) and lower HRM intensity (p = 0.033) at baseline than the others. Remarkably, the BCVA improved (p < 0.05) and the HRM height (p < 0.01) decreased only in eyes with a final BCVA better than 0.10 as early as 1 month after the initial treatment, which was still present at 12 months. The HRM height and intensity, not only the BCVA, would be valuable in evaluating the prognosis of myopic CNV after anti-VEGF therapy, although further study is required.
Highlights
The incidence of myopia is rising in East Asia [1], the US [2], and Europe [3], as reported in a 2015 News and Comments article in Nature titled “The Myopia Boom”
The mean values were significantly reduced 1 month after the initial treatment, and the effect was still present at 12 months (Figure 1b,c)
The best-corrected visual acuity (BCVA) improved and the hyperreflective material (HRM) decreased by intravitreal anti-VEGF therapy
Summary
The incidence of myopia is rising in East Asia [1], the US [2], and Europe [3], as reported in a 2015 News and Comments article in Nature titled “The Myopia Boom”. The diagnosis of myopic CNV is based on the clinical findings from fundus examinations, angiographies, and optical coherence tomography (OCT) [1,12]. Because it is non-invasive and requires a short recording time, OCT is widely utilized for the follow-up of myopic CNV and of other macular diseases in the daily clinic. OCT images are used to evaluate intraretinal conditions, including retinal edema [15,16] and disruptions of the ellipsoid zone (EZ) and external limiting membrane (ELM), which may reflect photoreceptor disorganization and affect the visual outcome [17,18,19], as well as subretinal lesions and/or fluid [19] in macular diseases. The results could help estimate its prognosis, which could be valuable for better informing the patients when securing their consent before treatment
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