Journal Mobile Options
Table of Contents
Vol. 227, No. 1, 2012
Issue release date: December 2011

Long-Term Follow-Up of Myopic Choroidal Neovascularization Treated with Ranibizumab

Franqueira N. · Cachulo M.L. · Pires I. · Fonseca P. · Marques I. · Figueira J. · Silva R.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Purpose: To evaluate the long-term safety and efficacy of intravitreal ranibizumab in the treatment of myopic choroidal neovascularization (CNV). Methods: Three-year retrospective, nonrandomized, interventional case series. Forty eyes of 39 patients with myopic CNV were included; 15 with previous photodynamic therapy, and 25 naïve eyes. Best-corrected visual acuity (BCVA) changes, central foveal thickness (CFT), and number of treatments were assessed, from baseline to month 36. Results: Mean visual acuity improved from 55.4 Early Treatment Diabetic Retinopathy Study (ETDRS) letters at baseline to 59.7 letters at 12 months (p = 0.07), 61.8 letters at 24 months (p = 0.008) and 63.4 letters at 36 months (p = 0.039). Twenty-five percent of the patients gained ≧15 letters (3 lines) at 12 months, 30% at 24 months and 35% at 36 months. There was a mean reduction of 80 µm in CFT (p < 0.001). A mean of 4.1 injections were performed in the first year, 2.4 in the second year and 1.1 in the third year. Fifty-three percent of the eyes had no need for treatment during the third year of follow-up. Conclusions: Intravitreal ranibizumab seems to be an effective and safe therapeutic procedure to treat CNV in highly myopic eyes, with a high proportion of patients gaining or stabilizing BCVA at a 3-year follow-up.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Soubrane G: Choroidal neovascularization in pathologic myopia: recent developments in diagnosis and treatment. Surv Ophthalmol 2008;53:121–138.
  2. Grossniklaus HE, Green WR: Pathologic findings in pathologic myopia. Retina 1992;12:127–133.
  3. Ohno-Matsui K, Yoshida T, Futagami S, Yasuzumi K, Shimada N, Kojima A, Tokoro T, Mochizuki M: Patchy atrophy and lacquer cracks predispose to the development of choroidal neovascularisation in pathological myopia. Br J Ophthalmol 2003;87:570–573.
  4. Cohen SY, Laroche A, Leguen Y, Soubrane G, Coscas GJ: Etiology of choroidal neovascularization in young patients. Ophthalmology 1996;103:1241–1244.
  5. Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL: Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology 1984;91:1573–1581.
  6. Hampton GR, Kohen D, Bird AC: Visual prognosis of disciform degeneration in myopia. Ophthalmology 1983;90:923–926.
  7. Tabandeh H, Flynn HW Jr, Scott IU, Lewis ML, Rosenfeld PJ, Rodriguez F, Rodriguez A, Singerman LJ, Schiffman J: Visual acuity outcomes of patients 50 years of age and older with high myopia and untreated choroidal neovascularization. Ophthalmology 1999;106:2063–2067.
  8. Yoshida T, Ohno-Matsui K, Ohtake Y, Takashima T, Futagami S, Baba T, Yasuzumi K, Tokoro T, Mochizuki M: Long-term visual prognosis of choroidal neovascularization in high myopia: a comparison between age groups. Ophthalmology 2002;109:712–719.
  9. Blinder KJ, Blumenkranz MS, Bressler NM, Bressler SB, Donato G, Lewis H, Lim JI, Menchini U, Miller JW, Mones JM, Potter MJ, Pournaras C, Reaves A, Rosenfeld P, Schachat AP, Schmidt-Erfurth U, Sickenberg M, Singerman LJ, Slakter JS, Strong HA, Virgili G, Williams GA, Verteporfin in Photodynamic Therapy Study Group: Verteporfin therapy of subfoveal choroidal neovascularisation in pathologic myopia: 2-year results of a randomized clinical trial – VIP report No 3. Ophthalmology 2003;110:667–672.
  10. Silva RM, Ruiz-Moreno JM, Nascimento J, Carneiro A, Rosa P, Barbosa A, Carvalheira F, Faria Abreu JR, Cunha-Vaz JG: Short-term efficacy and safety of intravitreal ranibizumab for myopic choroidal neovascularization. Retina 2008;28:1117–1123.
  11. Silva RM, Ruiz-Moreno JM, Rosa P, Carneiro A, Nascimento J, Rito LF, Cachulo ML, Carvalheira F, Murta JN: Intravitreal ranibizumab for myopic choroidal neovascularization: 12 months results. Retina 2010;30:407–417.
  12. Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S, ANCHOR Study Group: Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 2006;355:1432–1444.
  13. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY, MARINA Study Group: Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 2006;355:1419–1431.
  14. Tong JP, Chan WM, Liu DT, Lai TY, Choy KW, Pang CP, Lam DS: Aqueous humor levels of vascular endothelial growth factor and pigment epithelium-derived factor in polypoidal choroidal vasculopathy and choroidal neovascularization. Am J Ophthalmol 2006;141:456–462.
  15. Monés JM, Amselem L, Serrano A, Garcia M, Hijano M: Intravitreal ranibizumab for choroidal neovascularization secondary to pathologic myopia: 12-month results. Eye 2009;23:1275–1280.
  16. Lalloum F, Souied EH, Bastuji-Garin S, Puche N, Querques G, Glacet-Bernard A, Coscas G, Soubrane G, Leveziel N: Intravitreal ranibizumab for choroidal neovascularization complicating pathologic myopia. Retina 2010;30:399–406.
  17. Rosenfeld PJ, Rich RM, Lalwani GA: Ranibizumab: phase III clinical trial results. Ophthalmol Clin North Am 2006;19:361–372.

    External Resources

  18. Lai TY, Chan WM, Liu DT, Lam DS: Intravitreal ranibizumab for the primary treatment of choroidal neovascularization secondary to pathologic myopia. Retina 2009;29:750–756.
  19. Calvo-Gonzalez C, Reche-Futos J, Donate J, Fernandez-Perez C, Garcia-Feijoo J: Intravitreal ranibizumab for myopic choroidal neovascularization: factors predictive of visual outcome and need for retreatment. Am J Ophthalmol 2011;151:529–534.
  20. Geitzenauer W, Kiss CG, Durbin MK, Abunto MT, Callan TM, Stetson PF, Wieland MR, Bressler NM, Gregori G, Schmidt-Erfurth UM: Comparing retinal thickness measurements from Cirrus spectral domain- and Stratus time domain-optical coherence tomography. Retina 2010;30:596–606.
  21. Durbin M, Abunto T, Chang M, Lujan B: Retinal measurements: comparison between cirrus HD-OCT and stratus OCT. 2007. www.meditec.zeiss.com/C125679E00525939/ContainerTitel/CirrusOCT/$File/retinal-measurements.pdf. (accessed June 1, 2011).
  22. Abedi G, Patal P, Doros G, Subramanian ML: Transitioning from stratus OCT to cirrus OCT: a comparison and a proposed equation to convert central subfield macular thickness measurements in healthy subjects. Graefes Arch Clin Exp Ophthalmol 2011;249:1353–1357.
  23. Montero JA, Ruiz-Moreno JM: Verteporfin photodynamic therapy in highly myopic subfoveal choroidal neovascularisation. Br J Ophthalmol 2003;87:173–176.
  24. Axer-Siegel R, Ehrlich R, Weinberger D, Rosenblatt I, Shani L, Yassur Y, Priel E, Kramer M: Photodynamic therapy of subfoveal choroidal neovascularization in high myopia in a clinical setting: visual outcome in relation to age at treatment. Am J Ophthalmol 2004;138:602–607.
  25. Soubrane G, Coscas G: Choroidal neovascular membranes in degenerative myopia; in Ryan SJ, Ogden TE, Hinton DR, Schachat AP, Wilkinson CP (eds): Retina. St Louis, CV Mosby, 2006, vol 2: Medical Retina, pp 1115–1133.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50