Skip to main content
Erschienen in: International Ophthalmology 4/2020

02.12.2019 | Original Paper

Long-term outcomes of the intravitreal injection of ranibizumab for the treatment of choroidal neovascularization secondary to pathologic myopia

verfasst von: Ewa Wasiluk, Malgorzata Wojnar, Iwona Obuchowska, Zofia Mariak

Erschienen in: International Ophthalmology | Ausgabe 4/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To analyze the long-term outcomes and safety of intravitreal ranibizumab injections in myopic choroidal neovascularization (CNV).

Methods

A retrospective non-randomized analysis of consecutive cases included 17 eyes from 17 patients with subfoveal myopic CNV, treated with intravitreal ranibizumab with at least 30-month follow-up. The patients received three injections monthly, followed by pro re nata regimen. Best-corrected visual acuity (BCVA) measurement, optical coherence tomography and fluorescein angiography were carried out at the baseline and at monthly intervals thereafter.

Results

Mean follow-up period was 51 months (range 30–98 months). In 12 patients (70.6%), BCVA improved by at least 1 Snellen line, with at least 3-line improvement observed in the case of 8 eyes (47%). Mean central foveal thickness (CFT) decreased from 384.65 ± 103.3 µm at the baseline to 264 ± 86.2 µm at the last follow-up examination (p < 0.001). The final OCT examination revealed 59% (10/17) eyes with CNV-related macular atrophy. Mean number of injections over the follow-up period was 4.82 ± 2.04 per person. Nine patients (53%) required re-injection of the anti-VEGF agent; the mean number of re-injections in this group was 3.44 ± 1.34 per person (range 2–6). No significant adverse events were recorded during the study period.

Conclusions

Intravitreal ranibizumab is an effective and safe treatment for CNV secondary to pathologic myopia, contributing to long-term vision improvement and CFT reduction.
Literatur
1.
Zurück zum Zitat Yoshida T, Ohno-Matsui K, Yasuzumi K, Kojima A, Shimada N, Futagami S et al (2003) Myopic choroidal neovascularization: a 10-year follow-up. Ophthalmology 110(7):1297–1305PubMedCrossRef Yoshida T, Ohno-Matsui K, Yasuzumi K, Kojima A, Shimada N, Futagami S et al (2003) Myopic choroidal neovascularization: a 10-year follow-up. Ophthalmology 110(7):1297–1305PubMedCrossRef
2.
Zurück zum Zitat Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL (1984) Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology 91(12):1573–1581PubMedCrossRef Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL (1984) Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology 91(12):1573–1581PubMedCrossRef
3.
Zurück zum Zitat Ohno-Matsui K (2017) What is the fundamental nature of pathologic myopia? Retina 37(6):1043–1048PubMedCrossRef Ohno-Matsui K (2017) What is the fundamental nature of pathologic myopia? Retina 37(6):1043–1048PubMedCrossRef
4.
Zurück zum Zitat Grossniklaus HE, Green WR (1992) Pathologic findings in pathologic myopia. Retina 12(2):127–133PubMedCrossRef Grossniklaus HE, Green WR (1992) Pathologic findings in pathologic myopia. Retina 12(2):127–133PubMedCrossRef
5.
Zurück zum Zitat Lai TY, Cheung CM (2016) Myopic choroidal neovascularization: diagnosis and treatment. Retina 36(9):1614–1621PubMedCrossRef Lai TY, Cheung CM (2016) Myopic choroidal neovascularization: diagnosis and treatment. Retina 36(9):1614–1621PubMedCrossRef
6.
Zurück zum Zitat Wong TY, Ohno-Matsui K, Leveziel N, Holz FG, Lai TY, Yu HG et al (2015) Myopic choroidal neovascularisation: current concepts and update on clinical management. Br J Ophthalmol 99(3):289–296PubMedCrossRef Wong TY, Ohno-Matsui K, Leveziel N, Holz FG, Lai TY, Yu HG et al (2015) Myopic choroidal neovascularisation: current concepts and update on clinical management. Br J Ophthalmol 99(3):289–296PubMedCrossRef
7.
Zurück zum Zitat Cheung CMG, Arnold JJ, Holz FG, Park KH, Lai TYY, Larsen M et al (2017) Myopic choroidal neovascularization: review, guidance, and consensus statement on management. Ophthalmology 124(11):1690–1711PubMedCrossRef Cheung CMG, Arnold JJ, Holz FG, Park KH, Lai TYY, Larsen M et al (2017) Myopic choroidal neovascularization: review, guidance, and consensus statement on management. Ophthalmology 124(11):1690–1711PubMedCrossRef
8.
Zurück zum Zitat Wang E, Chen Y (2013) Intravitreal anti-vascular endothelial growth factor for choroidal neovascularization secondary to pathologic myopia: systematic review and meta-analysis. Retina 33(7):1375–1392PubMedCrossRef Wang E, Chen Y (2013) Intravitreal anti-vascular endothelial growth factor for choroidal neovascularization secondary to pathologic myopia: systematic review and meta-analysis. Retina 33(7):1375–1392PubMedCrossRef
9.
Zurück zum Zitat Wu TT, Kung YH (2017) Five-year outcomes of intravitreal injection of ranibizumab for the treatment of myopic choroidal neovascularization. Retina 37(11):2056–2061PubMedCrossRef Wu TT, Kung YH (2017) Five-year outcomes of intravitreal injection of ranibizumab for the treatment of myopic choroidal neovascularization. Retina 37(11):2056–2061PubMedCrossRef
10.
Zurück zum Zitat Lai TY (2012) Anti-vascular endothelial growth factor therapy for myopic choroidal neovascularization: do we need more evidence? Retina 32(8):1443–1445PubMedCrossRef Lai TY (2012) Anti-vascular endothelial growth factor therapy for myopic choroidal neovascularization: do we need more evidence? Retina 32(8):1443–1445PubMedCrossRef
11.
Zurück zum Zitat Wolf S, Balciuniene VJ, Laganovska G, Menchini U, Ohno-Matsui K, Sharma T et al (2014) RADIANCE: a randomized controlled study of ranibizumab in patients with choroidal neovascularization secondary to pathologic myopia. Ophthalmology 121(3):682–692PubMedCrossRef Wolf S, Balciuniene VJ, Laganovska G, Menchini U, Ohno-Matsui K, Sharma T et al (2014) RADIANCE: a randomized controlled study of ranibizumab in patients with choroidal neovascularization secondary to pathologic myopia. Ophthalmology 121(3):682–692PubMedCrossRef
12.
Zurück zum Zitat Kung YH, Wu TT, Huang YH (2014) One-year outcome of two different initial dosing regimens of intravitreal ranibizumab for myopic choroidal neovascularization. Acta Ophthalmol 92(8):e615–e620PubMedCrossRef Kung YH, Wu TT, Huang YH (2014) One-year outcome of two different initial dosing regimens of intravitreal ranibizumab for myopic choroidal neovascularization. Acta Ophthalmol 92(8):e615–e620PubMedCrossRef
13.
Zurück zum Zitat Lai TY, Chan WM, Liu DT, Lam DS (2009) Intravitreal ranibizumab for the primary treatment of choroidal neovascularization secondary to pathologic myopia. Retina 29(6):750–756PubMedCrossRef Lai TY, Chan WM, Liu DT, Lam DS (2009) Intravitreal ranibizumab for the primary treatment of choroidal neovascularization secondary to pathologic myopia. Retina 29(6):750–756PubMedCrossRef
14.
Zurück zum Zitat Wu TT, Kung YH (2012) The 12-month outcome of three consecutive monthly intravitreal injections of ranibizumab for myopic choroidal neovascularization. J Ocul Pharmacol Ther 28(2):129–133PubMedPubMedCentralCrossRef Wu TT, Kung YH (2012) The 12-month outcome of three consecutive monthly intravitreal injections of ranibizumab for myopic choroidal neovascularization. J Ocul Pharmacol Ther 28(2):129–133PubMedPubMedCentralCrossRef
15.
Zurück zum Zitat Silva RM, Ruiz-Moreno JM, Rosa P, Carneiro A, Nascimento J, Rito LF et al (2010) Intravitreal ranibizumab for myopic choroidal neovascularization: 12-month results. Retina 30(3):407–412PubMedCrossRef Silva RM, Ruiz-Moreno JM, Rosa P, Carneiro A, Nascimento J, Rito LF et al (2010) Intravitreal ranibizumab for myopic choroidal neovascularization: 12-month results. Retina 30(3):407–412PubMedCrossRef
16.
Zurück zum Zitat Tufail A, Narendran N, Patel PJ, Sivaprasad S, Amoaku W, Browning AC et al (2013) Ranibizumab in myopic choroidal neovascularization: the 12-month results from the REPAIR study. Ophthalmology 120(9):1944–1945PubMedCrossRef Tufail A, Narendran N, Patel PJ, Sivaprasad S, Amoaku W, Browning AC et al (2013) Ranibizumab in myopic choroidal neovascularization: the 12-month results from the REPAIR study. Ophthalmology 120(9):1944–1945PubMedCrossRef
17.
Zurück zum Zitat Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M et al (2013) Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 27(6):709–715CrossRef Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M et al (2013) Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 27(6):709–715CrossRef
18.
Zurück zum Zitat Lorenzo D, Arias L, Alcubierre R, Pujol O, Caminal JM, Rubio M et al (2011) Intravitreal ranibizumab for choroidal neovascularization secondary to pathological myopia: 12-month follow-up. Ophthalmologica 226(3):103–109PubMedCrossRef Lorenzo D, Arias L, Alcubierre R, Pujol O, Caminal JM, Rubio M et al (2011) Intravitreal ranibizumab for choroidal neovascularization secondary to pathological myopia: 12-month follow-up. Ophthalmologica 226(3):103–109PubMedCrossRef
19.
Zurück zum Zitat Lai TY, Luk FO, Lee GK, Lam DS (2012) Long-term outcome of intravitreal anti-vascular endothelial growth factor therapy with bevacizumab or ranibizumab as primary treatment for subfoveal myopic choroidal neovascularization. Eye (Lond) 26(7):1004–1011CrossRef Lai TY, Luk FO, Lee GK, Lam DS (2012) Long-term outcome of intravitreal anti-vascular endothelial growth factor therapy with bevacizumab or ranibizumab as primary treatment for subfoveal myopic choroidal neovascularization. Eye (Lond) 26(7):1004–1011CrossRef
20.
Zurück zum Zitat Franqueira N, Cachulo ML, Pires I, Fonseca P, Marques I, Figueira J et al (2012) Long-term follow-up of myopic choroidal neovascularization treated with ranibizumab. Ophthalmologica 227(1):39–44PubMedCrossRef Franqueira N, Cachulo ML, Pires I, Fonseca P, Marques I, Figueira J et al (2012) Long-term follow-up of myopic choroidal neovascularization treated with ranibizumab. Ophthalmologica 227(1):39–44PubMedCrossRef
21.
Zurück zum Zitat Ruiz-Moreno JM, Arias L, Montero JA, Carneiro A, Silva R (2013) Intravitreal anti-VEGF therapy for choroidal neovascularisation secondary to pathological myopia: 4-year outcome. Br J Ophthalmol 97(11):1447–1450PubMedCrossRef Ruiz-Moreno JM, Arias L, Montero JA, Carneiro A, Silva R (2013) Intravitreal anti-VEGF therapy for choroidal neovascularisation secondary to pathological myopia: 4-year outcome. Br J Ophthalmol 97(11):1447–1450PubMedCrossRef
22.
Zurück zum Zitat Peiretti E, Vinci M, Fossarello M (2012) Intravitreal bevacizumab as a treatment for choroidal neovascularisation secondary to myopia: 4-year study results. Can J Ophthalmol 47(1):28–33PubMedCrossRef Peiretti E, Vinci M, Fossarello M (2012) Intravitreal bevacizumab as a treatment for choroidal neovascularisation secondary to myopia: 4-year study results. Can J Ophthalmol 47(1):28–33PubMedCrossRef
23.
Zurück zum Zitat Gass JDM (1987) Stereoscopic atlas of macular diseases: diagnosis and treatment, 3rd edn. Mosby, St. Louis Gass JDM (1987) Stereoscopic atlas of macular diseases: diagnosis and treatment, 3rd edn. Mosby, St. Louis
24.
Zurück zum Zitat Chen Y, Sharma T, Li X, Song Y, Chang Q, Lin R et al (2019) Ranibizumab versus verteporfin photodynamic therapy in Asian patients with myopic choroidal neovascularization: brilliance, a 12-month, randomized, double-masked study. Retina 39(10):1985–1994PubMedCrossRef Chen Y, Sharma T, Li X, Song Y, Chang Q, Lin R et al (2019) Ranibizumab versus verteporfin photodynamic therapy in Asian patients with myopic choroidal neovascularization: brilliance, a 12-month, randomized, double-masked study. Retina 39(10):1985–1994PubMedCrossRef
25.
Zurück zum Zitat Ikuno Y, Ohno-Matsui K, Wong TY, Korobelnik JF, Vitti R, Li T et al (2015) Intravitreal aflibercept injection in patients with myopic choroidal neovascularization: the MYRROR study. Ophthalmology 122(6):1220–1227PubMedCrossRef Ikuno Y, Ohno-Matsui K, Wong TY, Korobelnik JF, Vitti R, Li T et al (2015) Intravitreal aflibercept injection in patients with myopic choroidal neovascularization: the MYRROR study. Ophthalmology 122(6):1220–1227PubMedCrossRef
26.
27.
Zurück zum Zitat Calvo-Gonzalez C, Reche-Frutos J, Donate J, Fernandez-Perez C, Garcia-Feijoo J (2011) Intravitreal ranibizumab for myopic choroidal neovascularization: factors predictive of visual outcome and need for retreatment. Am J Ophthalmol 151(3):529–534PubMedCrossRef Calvo-Gonzalez C, Reche-Frutos J, Donate J, Fernandez-Perez C, Garcia-Feijoo J (2011) Intravitreal ranibizumab for myopic choroidal neovascularization: factors predictive of visual outcome and need for retreatment. Am J Ophthalmol 151(3):529–534PubMedCrossRef
28.
Zurück zum Zitat Mones JM, Amselem L, Serrano A, Garcia M, Hijano M (2009) Intravitreal ranibizumab for choroidal neovascularization secondary to pathologic myopia: 12-month results. Eye (Lond) 23(6):1275–1280 (quiz 81) CrossRef Mones JM, Amselem L, Serrano A, Garcia M, Hijano M (2009) Intravitreal ranibizumab for choroidal neovascularization secondary to pathologic myopia: 12-month results. Eye (Lond) 23(6):1275–1280 (quiz 81) CrossRef
29.
Zurück zum Zitat Lalloum F, Souied EH, Bastuji-Garin S, Puche N, Querques G, Glacet-Bernard A et al (2010) Intravitreal ranibizumab for choroidal neovascularization complicating pathologic myopia. Retina 30(3):399–406PubMedCrossRef Lalloum F, Souied EH, Bastuji-Garin S, Puche N, Querques G, Glacet-Bernard A et al (2010) Intravitreal ranibizumab for choroidal neovascularization complicating pathologic myopia. Retina 30(3):399–406PubMedCrossRef
30.
Zurück zum Zitat Hefner L, Gerding H (2017) 6-Year results of CNV secondary to pathological myopia treated with ranibizumab. Klin Monbl Augenheilkd 234(4):483–486PubMedCrossRef Hefner L, Gerding H (2017) 6-Year results of CNV secondary to pathological myopia treated with ranibizumab. Klin Monbl Augenheilkd 234(4):483–486PubMedCrossRef
31.
Zurück zum Zitat Ruiz-Moreno JM, Montero JA, Araiz J, Arias L, Garcia-Layana A, Carneiro A et al (2015) Intravitreal anti-vascular endothelial growth factor therapy for choroidal neovascularization secondary to pathologic myopia: six years outcome. Retina 35(12):2450–2456PubMedCrossRef Ruiz-Moreno JM, Montero JA, Araiz J, Arias L, Garcia-Layana A, Carneiro A et al (2015) Intravitreal anti-vascular endothelial growth factor therapy for choroidal neovascularization secondary to pathologic myopia: six years outcome. Retina 35(12):2450–2456PubMedCrossRef
32.
Zurück zum Zitat Pastore MR, Capuano V, Bruyere E, Miere A, Corbelli E, Querques L et al (2018) Nine-year outcome of ranibizumab monotherapy for choroidal neovascularization secondary to pathologic myopia. Ophthalmologica 239(2–3):133–142PubMedCrossRef Pastore MR, Capuano V, Bruyere E, Miere A, Corbelli E, Querques L et al (2018) Nine-year outcome of ranibizumab monotherapy for choroidal neovascularization secondary to pathologic myopia. Ophthalmologica 239(2–3):133–142PubMedCrossRef
33.
Zurück zum Zitat Kasahara K, Moriyama M, Morohoshi K, Yoshida T, Simada N, Nagaoka N et al (2017) Six-year outcomes of intravitreal bevacizumab for choroidal neovascularization in patients with pathologic myopia. Retina 37(6):1055–1064PubMedCrossRef Kasahara K, Moriyama M, Morohoshi K, Yoshida T, Simada N, Nagaoka N et al (2017) Six-year outcomes of intravitreal bevacizumab for choroidal neovascularization in patients with pathologic myopia. Retina 37(6):1055–1064PubMedCrossRef
34.
Zurück zum Zitat Ventrice P, Leporini C, Aloe JF, Greco E, Leuzzi G, Marrazzo G et al (2013) Anti-vascular endothelial growth factor drugs safety and efficacy in ophthalmic diseases. J Pharmacol Pharmacother 4(Suppl 1):S38–S42PubMedPubMedCentral Ventrice P, Leporini C, Aloe JF, Greco E, Leuzzi G, Marrazzo G et al (2013) Anti-vascular endothelial growth factor drugs safety and efficacy in ophthalmic diseases. J Pharmacol Pharmacother 4(Suppl 1):S38–S42PubMedPubMedCentral
35.
Zurück zum Zitat Zhu H, Wang FH, Sun XD (2013) Anti-vascular endothelial growth factor: the future treatment of choroidal neovascularization in pathologic myopia? Chin Med J (Engl) 126(8):1578–1583 Zhu H, Wang FH, Sun XD (2013) Anti-vascular endothelial growth factor: the future treatment of choroidal neovascularization in pathologic myopia? Chin Med J (Engl) 126(8):1578–1583
36.
Zurück zum Zitat Hashemi S, Faramarzi MA, Ghasemi Falavarjani K, Abdollahi M (2014) Bevacizumab for choroidal neovascularization secondary to age-related macular degeneration and pathological myopia. Expert Opin Biol Ther 14(12):1837–1848PubMedCrossRef Hashemi S, Faramarzi MA, Ghasemi Falavarjani K, Abdollahi M (2014) Bevacizumab for choroidal neovascularization secondary to age-related macular degeneration and pathological myopia. Expert Opin Biol Ther 14(12):1837–1848PubMedCrossRef
Metadaten
Titel
Long-term outcomes of the intravitreal injection of ranibizumab for the treatment of choroidal neovascularization secondary to pathologic myopia
verfasst von
Ewa Wasiluk
Malgorzata Wojnar
Iwona Obuchowska
Zofia Mariak
Publikationsdatum
02.12.2019
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 4/2020
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-019-01247-w

Weitere Artikel der Ausgabe 4/2020

International Ophthalmology 4/2020 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.