Is Ranibizumab effective in stopping loss of vision secondary to Choroidal Neovascularization in Pathologic Myopia? A Long Term Follow-up Study.

Purpose: To assess the efficacy and safety of Ranibizumab in the treatment of choroidal neovascularization (CNV) caused by pathologic myopia (PM). Design: Prospective, multicenter, interventional case series. Methods: 40 of 39 consecutive patients with PM and CNV were treated with “on-demand” intravitreal injection of ranibizumab 0.5 mg. Final best-corrected VA (BCVA) and its change from baseline were the main outcome measures. Changes in Optical Coherence Tomography (OCT) central retinal thickness (CRT) were a secondary outcome. Results: Mean age was 53 ± 13 years, mean refractive error -13.5 ± 6.5 diopters. Median follow-up was 13.3 ± 2 months (range 12 – 18). Fifteen eyes (37.5%) had previously been treated with photodynamic therapy (PDT). The mean baseline logMAR BCVA (ETDRS vision chart) was 0.68 ± 0.34 (Snellen equivalent 20/131) and 21 ± 16 letters. The final mean logMAR BCVA was 0.27 ± 0.2 (p 0.008) (20/42) and 40.5 ± 14 letters (p 0.01). Mean final VA improved in 82.5% of patients, in 60% by 3 or more lines,(median number of lines gained 2.9). Even six out of seven cases of low vision (≤ 1.1 LogMAR) at the final examination improved vision. Mean OCT CRT reduced from 218±70 μm to 175±46 μm (p 0.02). Age and previous PDT did not influence results (p›0,05). The mean number of injection was 2.8 ± 1.2 (range 1-6). No ocular or systemic side effects were observed. Conclusion: Ranibizumab was an effective treatment for stabilizing and improving vision in 92.5 % of myopic CNV in a long term follow-up with a low number of injections.