Pharmacotherapy of Myopic Choroidal Neovascularization

2019 ◽  
Vol 24 (41) ◽  
pp. 4853-4859 ◽  
Author(s):  
Hacer Isildak ◽  
Stephen G. Schwartz ◽  
Harry W. Flynn
Keyword(s):  
Choroidal Neovascularization ◽  
Treatment Options ◽  
Lesion Size ◽  
Pharmacologic Therapy ◽  
Myopic Choroidal Neovascularization ◽  
First Line Therapy ◽  
Anti Vegf ◽  
The Us ◽  
Endothelial Growth Factor ◽  
Myopic Cnv

Background: Myopic choroidal neovascularization (CNV) is a common cause of central visual loss in patients with high myopia, and the most common form of CNV in younger individuals. Pharmacologic therapy is the current mainstay of treatment of these patients. Methods: Review of pharmacological treatment options for myopic CNV, which primarily involves intravitreal administration of anti-vascular endothelial growth factor (anti-VEGF) agents. Results: At this time, anti-VEGF therapy agents are the first-line therapy in these patients. Comparative trials have not identified any major differences in treatment outcomes between aflibercept, bevacizumab, and ranibizumab. Only ranibizumab is approved for this indication in the US. Best visual outcomes are associated with younger age, smaller lesion size, and absence of chorioretinal atrophy. Conclusion: Anti-VEGF therapy is generally very effective in the treatment of myopic CNV.

scholarly journals Hyperreflective Material in Optical Coherence Tomography Images of Eyes with Myopic Choroidal Neovascularization May Affect the Visual Outcome

2020 ◽  
Vol 9 (8) ◽  
pp. 2394
Author(s):  
Yasuaki Mushiga ◽  
Sakiko Minami ◽  
Atsuro Uchida ◽  
Norihiro Nagai ◽  
Misa Suzuki ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Neovascularization ◽  
Initial Treatment ◽  
Visual Outcome ◽  
Optical Coherence ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf ◽  
The Mean ◽  
Better Than ◽  
Myopic Cnv

The visual outcome of myopic choroidal neovascularization (CNV) after anti-vascular endothelial growth factor (anti-VEGF) therapy varies among individuals. We retrospectively analyzed the data of 24 eyes (24 patients) with treatment-naïve myopic CNV who underwent anti-VEGF monotherapy following a pro-re-nata regimen at the Division of Medical Retina Clinic, Department of Ophthalmology, Keio University Hospital between May 2014 and December 2017. The mean age was 70.6 ± 2.1 years, and 16 (66.7%) patients were female. Overall, the mean best-corrected visual acuity (BCVA) improved (p = 0.034), and the mean height of the hyperreflective material (HRM), involving the CNV lesion recorded by optical coherence tomography, decreased (p < 0.01) 12 months after the initial treatment. Fifteen eyes (62.5%) achieved a BCVA of better than 0.10 in LogMAR at 12 months; they had a better BCVA (p = 0.015) and lower HRM intensity (p = 0.033) at baseline than the others. Remarkably, the BCVA improved (p < 0.05) and the HRM height (p < 0.01) decreased only in eyes with a final BCVA better than 0.10 as early as 1 month after the initial treatment, which was still present at 12 months. The HRM height and intensity, not only the BCVA, would be valuable in evaluating the prognosis of myopic CNV after anti-VEGF therapy, although further study is required.

scholarly journals Macular density alterations in myopic choroidal neovascularization and the effect of anti-VEGF on it

2021 ◽  
Vol 14 (8) ◽  
pp. 1205-1212
Author(s):  
Jian-Bo Mao ◽  
◽  
Jia-Feng Yu ◽  
Xin-Yi Deng ◽  
Chen-Yi Liu ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Capillary Density ◽  
Normal Group ◽  
Reduction Ratio ◽  
Vessel Density ◽  
Lesion Area ◽  
Flow Area ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf ◽  
The Mean

AIM: To analyse macular microvascular alterations in myopic choroidal neovascularization (mCNV) and the efficiency of anti-vascular endothelial growth factor (anti-VEGF) therapy for mCNV by optical coherence tomography angiography (OCTA). METHODS: A total of 123 patients were included in this retrospective study, divided into mCNV group, high myopia (HM) group, and normal group at the Affiliated Eye Hospital of Wenzhou Medical University from January 2017 to January 2019. Superficial vessel density, deep capillary density, foveal avascular zone (FAZ) area, A-circularity index (AI) and vessel density around the 300 μm width of the FAZ region density (FD) and the area of choroidal neovascularization (CNV) lesion (only for mCNV group) were measured on 3×3 mm2 OCTA images. FAZ area was corrected for axial length. Central macular thickness (CMT) was measured on OCT in mCNV group. Compared the parameters on OCTA of 3 groups and pre-anti-VEGF and post-anti-VEGF at 1, 2, 3, and 6mo follow-up in mCNV group. RESULTS: There were significant differences among 3 groups in superficial vessel density, deep capillary density and FD (P<0.05). FAZ area in HM group was smaller than normal group (P<0.05), but there was no significant difference between mCNV group and the other two group. AI increased in mCNV group (P<0.05). The mean CMT, area and flow area of CNV lesion decreased after treatment (P<0.05), while vessel density and FAZ didn’t change. The mean CMT, area and flow area of CNV lesion statistically decreased after anti-VEGF treatment in mCNV group (P<0.05), while superficial vessel density, deep capillary density and FAZ area, AI and FD didn’t change. The mean reduction ratio of lesions was 50.32% (7.07% to 100%). Lesion regression 100% was observed in 2 cases (4.88%). There was a negative correlation between the CNV lesion area and reduction ratio (r=-0.380, P=0.042) and the flow lesion area and reduction ratio (r=-0.402, P=0.030). CONCLUSION: Macular vessel density decreases, FAZ turns smaller and more irregular in mCNV eyes. Anti-VEGF therapy is efficient for mCNV without affecting vessel density and FAZ, but it is unable to completely eliminate CNV lesions in most cases. The bigger mCNV lesions have lower reduction ratio.

Anti-VEGF Therapy in Myopic Choroidal Neovascularization: Long-Term Results

2014 ◽  
Vol 232 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Paulo Freitas-da-Costa ◽  
João Pinheiro-Costa ◽  
Beatriz Carvalho ◽  
Manuel Falcão ◽  
Elisete Brandão ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Long Term Results ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf

Management of Myopic Choroidal Neovascularization: Focus on Anti-VEGF Therapy

Drugs ◽  
2016 ◽  
Vol 76 (11) ◽  
pp. 1119-1133 ◽  
Author(s):  
Kelvin Yi Chong Teo ◽  
Wei Yan Ng ◽  
Shu Yen Lee ◽  
Chui Ming Gemmy Cheung
Keyword(s):  
Choroidal Neovascularization ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf

scholarly journals Result of Intravitreal Aflibercept Injection for Myopic Choroidal Neovascularization

2021 ◽  
Author(s):  
Shih-Lin Chen ◽  
Tsung-Tien Wu ◽  
Pei-Ling Tang
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Minimum Duration ◽  
Foveal Thickness ◽  
Flow Area ◽  
Myopic Choroidal Neovascularization ◽  
Central Foveal Thickness ◽  
Intravitreal Aflibercept ◽  
Myopic Cnv

Abstract Background: The current study aimed to evaluate the efficacy of intravitreal aflibercept injections as the primary treatment for subfoveal/juxtafoveal myopic choroidal neovascularization (CNV) using optical coherence tomography angiography (OCTA) to detect the changes in shape, size, and flow area pertaining to CNV, with a minimum duration of follow-up of one year. Methods: In the present study, 21 treatment-naive eyes of 21 patients with subfoveal/juxtafoveal myopic CNV received primary intravitreal aflibercept injections and were under follow-up for a minimum duration of 12 months. Among the 21 patients, 12 underwent OCTA to evaluate the changes in central foveal thickness, selected CNV area, and flow area. Results: The mean best-corrected visual acuity (BCVA) pertaining to all the patients significantly improved from the baseline value of 0.7 to 0.3 logMAR after treatment for 12 months (P = 0.001). However, the improvements in the median BCVA after treatment for three and twelve months were not statistically significant in the younger group (< 50 years), compared to the older group (≥ 50 years). A single aflibercept injection resolved the CNV in 47.6% (10/21) of the patients. The younger group displayed greater improvement in the median central foveal thickness, compared to the older group. OCTA revealed interlacing or disorganized patterns at the level of the outer retinal layer in 12 among the 21 subjects with myopic CNV. After three months of treatment, both the groups displayed a decrease in the size of the selected CNV area and flow area. The interlacing group displayed a trend towards better anatomical improvements. Conclusion: Intravitreal aflibercept injection provides long-term improvement in visual acuity in patients with myopic CNV. A single aflibercept injection was observed to resolve myopic CNV in approximately half of the patients. The interlacing group displayed greater resolution of the selected CNV area and flow area after aflibercept injection. Trial registration: Before data collection, written informed consent was obtained from each participant, whose identity information was protected by encryption and conversion to a non-identifiable format and removing data links. This study was approved by the Institutional Review Board of Kaohsiung Veterans General Hospital (KSVGH21-CT1-17).

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