Comparison of photodynamic therapy, ranibizumab/bevacizumab or combination in the treatment of myopic choroidal neovascularisation: a 9-year-study from a single centre

The British Journal of Ophthalmology
Pukhraj RishiTarun Sharma

Abstract

To compare treatment outcomes for myopic choroidal neovascularisation (CNV) managed with verteporfin photodynamic therapy (vPDT), intravitreal antivascular endothelial growth factor (anti-VEGF, bevacizumab/ranibizumab) agents or combination thereof. Clinical data of 79 eyes with myopic CNV examined from March 2004 to July 2013 was retrospectively reviewed. Patients were managed with vPDT, intravitreal bevacizumab (1.25 mg/0.05 mL)/ranibizumab (0.5 mg/0.05 mL) or a combination of vPDT and anti-VEGF. Outcome measures included complete regression (scarring) of CNV and best-corrected visual acuity (BCVA). Treatments provided were vPDT (n=23), anti-VEGF (n=25) (ranibizumab, n=12; bevacizumab, n=13), vPDT+anti-VEGF (n=31). Mean logMAR BCVA changed from 0.59±0.44 to 0.49±0.40 at mean follow-up of 54.63±39.46 months. Mean logMAR vision changed from 0.68±0.57, 0.54±0.48 and 0.59±0.39 at presentation to 0.59±0.53, 0.38±0.44 and 0.37±0.37 at last follow-up in PDT (p=0.4), anti-VEGF (p=0.1) and vPDT+anti-VEGF groups (p=0.0002), respectively. CNV was scarred in 64 eyes (81%) at mean 11.03±13.56 months. Most common complication was macular scar (n=64), associated with reduced (n=17) or preserved (n=47) vision. Chorioretinal atrophy attributa...Continue Reading

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