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The efficacy of different anti-vascular endothelial growth factor agents and prognostic biomarkers in monitoring of the treatment for myopic choroidal neovascularization

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Abstract

Purpose

To evaluate anatomical and visual results of eyes with naive myopic choroidal neovascularization (mCNV) in patients treated with intravitreal anti-vascular endothelial growth factor (VEGF) therapies.

Material and methods

This is a retrospective, non-randomized, comperative, intervetional study. One hundred fourteen eyes of 114 patients with mCNV who underwent intravitreal bevacizumab (IVB), intravitreal ranibizumab (IVR) or intravitreal aflibercept (IVA) monotherapy injections were enrolled into the study. The best corrected visual acuity (BCVA), central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) were compared among the groups during the follow-up periods at the beginning, months 1, 3, 6, 12, and the final visit.

Results

The mean age of the patients was 47.76 ± 10.57 years (range, 33–72 years) and the mean follow-up period was 23.34 ± 6.81 months (range, 13–38 months). The mean BCVA denoted a significantly improve at each group (p < 0.05). In terms of an inter-group analysis of all 3 groups, at months 1, 6, and 12 and final visit, the BCVA were statistically significantly better in the IVA group when compared to both IVB and IVR groups (p = 0.021, p = 0.032, p = 0.024, p = 0.012). There was a significant decrease in CMT following IVB (236.49 ± 40.91 μm–190.74 ± 50.12 μm), IVA (232.91 ± 46.29 μm–193.73 ± 46.81 μm) and IVR (234.78 ± 45.37 μm–192.21 ± 37.27 μm) between baseline and final visit (p = 0.018, p = 0.002, p < 0.001, respectively). There was a statistically significant decrease in SFCT values between baseline and final examination only in the IVA group (p < 0.001). The mean number of injections were 9.18 ± 3.18 (range; 3 to 13) in IVB, 6.46 ± 2.93 (range; 3–11) in IVR and 4.45 ± 1.42 (range; 2–7) in IVA (p = 0.028).

Conclusion

All three anti-VEGFs were found to be effective in terms of visual results in patients with mCNV. However, we demonstrated that IVA reduces the need for anti-VEGF when compared to patients who received both IVB and IVR. Furthermore, IVA induced a prominent reduction in SFCT, whereas IVR and IVB did not have a significant action on SFCT.

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This research received no specific grant from any funding agency in the public, commercial, or not for-profit sectors.

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Authors and Affiliations

  1. Department of Ophthalmology, Tuzla State Hospital, İçmeler Mahallesi, Piri Reis Caddesi, No: 74 Tuzla/İstanbul, 34947, Istanbul, Turkey

    Buğra Karasu

  2. Department of Ophthalmology, Beyoglu Eye Research and Training Hospital, Istanbul, Turkey

    Buğra Karasu

  3. Department of Ophthalmology Istanbul, School of Medicine, Acibadem University, Istanbul, Turkey

    Ali Rıza Cenk Celebi

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  1. Buğra Karasu
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Correspondence to Buğra Karasu.

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Author Bugra Karasu declares that he has no conflict of interest. Author Ali Rıza Cenk Celebi declares that he has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained prior to every surgical procedure from all individual participants included in the study.

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Karasu, B., Celebi, A.R.C. The efficacy of different anti-vascular endothelial growth factor agents and prognostic biomarkers in monitoring of the treatment for myopic choroidal neovascularization. Int Ophthalmol 42, 2729–2740 (2022). https://doi.org/10.1007/s10792-022-02261-1

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  • DOI: https://doi.org/10.1007/s10792-022-02261-1

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