Vascular endothelial growth factor inhibitors for predominantly Caucasian myopic choroidal neovascularization: 2-year treatment outcomes in clinical practice: data from the Fight Retinal Blindness! Registry.

Pierre‐Henry Gabrielle,Catherine Creuzot‐Garcher,Lucia Miguel,Socorro Alforja,Ricardo P Casaroli‐Marano,Daniel Barthelmes,Laura Sararols,Vuong Nguyen,Javier Zarranz‐Ventura,Jennifer Arnold,Mark Gillies

doi:10.1111/aos.14893

Abstract

PurposeTo report the 24‐month outcomes of vascular endothelial growth factor (VEGF) inhibitors for myopic choroidal neovascularization (mCNV) in predominantly Caucasian eyes in routine clinical practice.MethodsRetrospective analysis of treatment‐naïve eyes starting intravitreal injection of VEGF inhibitors of either bevacizumab (1.25 mg) or ranibizumab (0.5 mg) for mCNV from 1 January 2006 to 31 May 2018 that were tracked in the Fight Retinal Blindness! registry.ResultsWe identified 203 eyes (bevacizumab–85 and ranibizumab–118) of 189 patients. The estimated mean (95% CI) change in VA over 24 months for all eyes using longitudinal models was +8 (5, 11) letters with a median (Q1, Q3) of 3 (2, 5) injections given mostly during the first year. The estimated mean change in VA at 24 months was similar between bevacizumab and ranibizumab [+9 (5, 13) letters for bevacizumab versus +9 (6, 13) letters for ranibizumab; p = 0.37]. Both agents were also similar in the mCNV activity outcomes, treatment frequency and visit frequency.ConclusionsThe 24‐month treatment outcomes of VEGF inhibitors for mCNV were favourable in this largest series yet reported of predominantly Caucasian eyes in routine clinical practice, with approximately two lines of visual gain and a median of three injections given mostly during the first year. These outcomes are similar to those reported for predominantly Asian eyes. Bevacizumab appeared to be as safe and effective as ranibizumab.

Highlights

Realworld evidence from observational studies is helpful to understand treatment effectiveness and patterns in routine clinical practice and unmet needs in the management of a condition (Sherman et al 2016)
Information on long-term treatment outcomes and comparison of vascular endothelial growth factor (VEGF) inhibitors for myopic choroidal neovascularization (mCNV) is still limited to only one randomized control trials (RCT), one meta-analysis of prospective case series and a few small comparative and non-comparative observational studies, which included mainly patients of
This was a retrospective analysis of treatment-na€ıve eyes that had received intravitreal VEGF inhibitors for mCNV, defined as a new diagnosis of CNV in eyes with investigator-reported high myopia [refractive error of À6.00 Diopters (D) or greater myopia or axial length of 26.5 mm or greater] associated with myopic lesions of the posterior pole tracked in the prospectively designed observational database – The Fight Retinal Blindness! (FRB!) Registry (Gillies et al 2014)

Summary

Introduction

Registrational trials, randomized control trials (RCT), meta-analyses and observational studies have confirmed vascular endothelial growth factor (VEGF) inhibitors as the first-line treatment for myopic choroidal neovascularization (mCNV) with better outcomes than previous treatments such as photodynamic therapy (PDT) or laser photocoagulation (Gharbiya et al 2010; Parodi et al 2010; Lai et al 2012; Tufail et al 2013; Wang & Chen 2013; Wolf et al 2014; Ikuno et al 2015; Pece et al 2015; Holz et al 2016; Ohno-Matsui et al 2018; Tan et al 2018; Hamilton et al 2020). This study aimed to assess the 24-month treatment outcomes of VEGF inhibitors for mCNV in patients of predominantly Caucasian ethnicity and explore factors that predicted visual function and lesion activity in routine clinical practice

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