PURPOSE: To report long-term treatment outcomes of intravitreal bevacizumab (IVB) in myopic macular neovascularization (MNV).
METHODS: Retrospective analysis of longitudinal, clinical data of high myopic MNV patients treated with IVB. One-hundred-seventeen eyes of 106 patients were followed from first injection up to 12 years. Outcome measures were best-corrected visual acuity (BCVA) change during follow-up and myopic MNV recurrence.
RESULTS: Mean (±SD) baseline BCVA (0.56±0.46 LogMar, 20/80) significantly improved after first treatment (0.33±0.33, 20/50, P<0.001). At 4 years (n= 86) BCVA was no longer significantly better than at baseline (0.55±0.57, P = 0.30) and continued to deteriorate to 0.83±0.76 (20/125) at 10 years (n=27). Of the 27 eyes (23%) who reached 10 years of follow-up, 53% developed MNV-related chorioretinal atrophy (CRA). The cumulative incidence of recurrent myopic MNV was 34% at 2 years and 59% at 5 years. BCVA decrease in eyes with or without recurrent MNV was similar (P=0.58). Patchy CRA (HR 3.0, P=0.02) and subfoveal MNVs (HR 2.5, P=0.048) were significantly associated with recurrent MNV.
CONCLUSION: This retrospective myopic MNV study revealed that visual improvement after IVB injections was not maintained over time. MNV recurrences occurred frequently but did not alter the already poor visual prognosis.