TY - JOUR
T1 - Long-term Treatment Outcomes After Bevacizumab Therapy for Macular Neovascularization in White Patients with High Myopia
AU - Ravenstijn, Monica
AU - Klaver, Caroline C W
AU - Yzer, Suzanne
N1 - Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Opthalmic Communications Society, Inc.
PY - 2023/3
Y1 - 2023/3
N2 - PURPOSE: To report long-term treatment outcomes of intravitreal bevacizumab in myopic macular neovascularization (MNV).METHODS: Retrospective analysis of longitudinal, clinical data of patients with high myopic MNV treated with intravitreal bevacizumab. One-hundred and seventeen eyes of 106 patients were followed from first injection up to 12 years. Outcome measures were best-corrected visual acuity change during follow-up and myopic MNV recurrence.RESULTS: Mean (±SD) baseline best-corrected visual acuity (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), best-corrected visual acuity was no longer significantly better than at baseline (0.55 ± 0.57, P = 0.30) and continued to deteriorate to 0.84 ± 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. The cumulative incidence of recurrent myopic MNV was 34% at 2 years and 59% at 5 years. Best-corrected visual acuity decrease in eyes with or without recurrent MNV was similar ( P = 0.58). Patchy chorioretinal atrophy (hazard ratio 3.0, P = 0.02) and subfoveal MNVs (hazard ratio 2.5, P = 0.048) were significantly associated with recurrent MNV.CONCLUSION: This retrospective myopic MNV study revealed that visual improvement after intravitreal bevacizumab injections was not maintained over time. Macular neovascularization recurrences occurred frequently but did not alter the already poor visual prognosis.
AB - PURPOSE: To report long-term treatment outcomes of intravitreal bevacizumab in myopic macular neovascularization (MNV).METHODS: Retrospective analysis of longitudinal, clinical data of patients with high myopic MNV treated with intravitreal bevacizumab. One-hundred and seventeen eyes of 106 patients were followed from first injection up to 12 years. Outcome measures were best-corrected visual acuity change during follow-up and myopic MNV recurrence.RESULTS: Mean (±SD) baseline best-corrected visual acuity (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), best-corrected visual acuity was no longer significantly better than at baseline (0.55 ± 0.57, P = 0.30) and continued to deteriorate to 0.84 ± 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. The cumulative incidence of recurrent myopic MNV was 34% at 2 years and 59% at 5 years. Best-corrected visual acuity decrease in eyes with or without recurrent MNV was similar ( P = 0.58). Patchy chorioretinal atrophy (hazard ratio 3.0, P = 0.02) and subfoveal MNVs (hazard ratio 2.5, P = 0.048) were significantly associated with recurrent MNV.CONCLUSION: This retrospective myopic MNV study revealed that visual improvement after intravitreal bevacizumab injections was not maintained over time. Macular neovascularization recurrences occurred frequently but did not alter the already poor visual prognosis.
KW - Angiogenesis Inhibitors
KW - Antibodies, Monoclonal, Humanized/therapeutic use
KW - Atrophy/drug therapy
KW - Bevacizumab/therapeutic use
KW - Choroidal Neovascularization/drug therapy
KW - Follow-Up Studies
KW - Humans
KW - Intravitreal Injections
KW - Myopia, Degenerative/complications
KW - Retrospective Studies
KW - Treatment Outcome
KW - Vascular Endothelial Growth Factor A
KW - Visual Acuity
KW - White
UR - https://www.mendeley.com/catalogue/1449a37c-ca26-372b-99de-25ee0ca712cf/
U2 - 10.1097/IAE.0000000000003675
DO - 10.1097/IAE.0000000000003675
M3 - Article
C2 - 36395427
SN - 0275-004X
VL - 43
SP - 444
EP - 453
JO - Retina
JF - Retina
IS - 3
ER -