Prognostic Factors of Eyes With Naïve Subfoveal Myopic CNV Following Intravitreal Bevacizumab
The authors of the following retrospective observational case series aimed to determine the efficacy of one intravitreal bevacizumab injection followed by pro re nata (1 + PRN) injection in cases of subfoveal myopic choroidal neovascularization (CNV) and to identify CNV-recurrence-related prognostic factors.
In total, 103 eyes of 89 consecutive naive patients who had subfoveal myopic CNV and had been followed-up for at least two years were included. Of those eyes, 24 had recurrences. The remaining eyes were stable after the initial treatment.
The study authors reported that the average patient age was 51.1 ± 15.2 years and that the average follow-up duration was 44.1 ± 12.7 months. At baseline and at the one-year, two-year and final visits, they found that the average best-corrected visual acuities (BCVAs) were 0.57 ± 0.45, 0.38 ± 0.51, 0.40 ± 0.52 and 0.41 ± 0.41 logMAR, respectively. They also noted that the recurrence rate during follow-up was 23.3%. Additionally, the BCVA improved by 0.2 logMAR after 2.7 injections in the eyes without recurrence but by only 0.08 logMAR after 6.9 injections in the eyes with recurrence. In univariate analysis, the authors associated recurrence with older age, more myopic refraction, thinner choroid, larger CNV lesions and subfoveal hemorrhage at baseline. In multivariate analysis, only baseline CNV lesion size associated significantly with CNV recurrence (p=0.002). Recurrence, baseline BCVA, choroidal thickness and CNV size associated significantly with final BCVA (p=0.026, <0.0001, 0.007 and 0.002, respectively). Baseline choroidal thickness, CNV size, age and presence of lacquer cracks associated significantly with injection number (p<0.0001, <0.0001, 0.026 and 0.035, respectively).
The authors of this case series concluded that 1 + p.r.n. intravitreal bevacizumab monotherapy effectively stabilized subfoveal myopic CNV. The CNV size, the baseline BCVA and the choroidal thickness were the main prognostic factors of subfoveal myopic CNV after 1.0 + p.r.n. injection of bevacizumab.