Iacono P, et al. - This research strived to discern the prognostic variables relative to myopic choroidal neovascularization (CNV), treated with intravitreal ranibizumab/bevacizumab. The ranibizumab/bevacizumab therapy proved to be effective in improving and maintaining the visual acuity in myopic choroidal neovascularization. A strong connection was ascertained between early diagnosis, better baseline BCVA, and hyperfundus autofluorescence CNV pattern with better functional outcomes. CNV distinguished by its small size and low CMT appeared to respond more favorably. It yielded a better visual outcome.

Methods

• The eligible candidates included 48 patients with myopic CNV.
• The design of this research was a prospective, interventional, non-randomized 12-month study.
• Intravitreal ranibizumab/bevacizumab was administered in a pro-re-nata regimen and re-treatment was performed in the presence of angiographic leakage, intraretinal/subretinal fluid on optical coherence tomography, new hemorrhages, five-letter decrease and increased metamorphosia.
• The primary outcome measures constituted the detection of the predictive value of symptom duration, patient's age, refractive error, best-corrected visual acuity (BCVA), central macular thickness (CMT), CNV area, CNV location, retinal hemorrhages, atrophy, lacquer cracks, and CNV-fundus autofluorescence pattern (hyper-fundus autofluorescence/patchy pattern).
• Patients requiring either one or two injections to achieve CNV stabilization served as the secondary outcome.

Results

• The mean BCVA improved from 0.49 ± 0.30 (logarithm of minimal angle resolution, Snellen equivalent 20/63) to 0.39 ± 0.32 (20/49) at 1-year follow-up (P = 0.043).
• The baseline BCVA (P = 0.0003), symptom duration (P = 0.005), CMT (P = 0.02), and fundus autofluorescence pattern (P = 0.005) as the explanatory variables on the final BCVA and the change in the mean BCVA, was determined via univariate and multiple stepwise linear regression analysis.
• Patients with better baseline BCVA, early diagnosis, lower CMT, or disclosing a hyperfundus autofluorescence CNV pattern reported better visual outcomes.
• Improved visual outcomes were found in patients responding with just one to two intravitreal injections (45.8%) compared with patients receiving three or more injections.
• This group comprised of younger patients with lesser CMT, smaller CNV area, and fewer baseline hemorrhages.