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

Abstract

Abstract Purpose To report the anatomical and visual outcome 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, 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 t test for paired data). Changes in OCT were not significant for either group by the end of follow up. The mean number of total injections were 3.2 (Group 1) vs 1.7 (Group 2) (p=0.00, Mann‐Whitney test). Four recurrences (four eyes) occurred in Group 1 vs fifteen (seven eyes) in Group 2 (p=0.001; Fisher exact test). Conclusion Both initial treatment have similar results improving BCVA. Group 1 was treated by a higher number of injections achieving a longer lasting inactivation of myopic CNV, reducing the number of recurrences during the first year.