https://doi.org/10.31288/oftalmolzh201753438

Comparison of intravitreal ranibizumab and aflibercept in patients with choroidal neovascularization in pathologic myopia

О.M. Blavatska1, T.B. Kustryn2, A.R. Korol2, Dr Med Sc

1Danylo Halytsky Lviv National Medical University

2Filatov Institute of Eye Disease and Tissue Therapy, Odessa

E-mail:  syannya@rambler.ru, laserfilatova@gmail.com                 

Purpose. To compare the efficacy of ranibizumab and aflibercept treatment of patients with choroidal neovascularization (CNV) in pathologic myopia.

Material and Methods. This was a comparative, uncontrolled, prospective cohort study, enrolling 96 pathologic myopic eyes (93 patients) with subretinal neovascularization.

Results. 65 eyes (63 patients) were treated with 0.5 mg intravitreal  ranibizumab; 31 eyes (30 patients) were treated by 2 mg intravitreal aflibercept. The baseline mean visual acuity was 0.2 and 0.21 in the intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) groups, respectively. At 12 months, the mean visual acuity was 0.4 and 0.37 for the IVR and IVA groups, respectively. The mean CRT at baseline was 314.6 µm and 276.5 µm for the IVR and IVA groups, respectively. At 12 months, the mean CRT was 226.7 µm (р = 0.000) and 224.3 µm (р = 0.000) for the IVR and IVA groups, respectively. The mean number of injections in the IVR and IVA groups was 2.3 (0.9) and 2.6 (0.9), respectively.  No statistically significant difference was noted in the number of injections between groups (р = 0.15).

Conclusions. Both ranibisumab and aflibercept were found to improve the visual acuity in pathologic myopic patients with CNV with no statistically significant difference in the number of intravitreal injections.

Key-words: pathologic myopia, choroidal neovascularization, ranibisumab and aflibercept 

References 

1.Medvedev IB, Belikova EI, Syamichev M.P. [Photodynamic therapy in ophthalmology]. OOO “GUPT “Krasnyi voin””; 2006. 152 p. In Russian. 

2.Blinder KJ, Blumenkranz MS, Bressler NM, et al.  Verteporfin therapy of subfoveal choroidal neovascularization in pathologic myopia: 2-year results of a randomized clinical trial FVIP report no. 3. Ophthalmology. 2003; 110:667–673.
Crossref   Pubmed

3.Brown DM, Campochiaro PA, Singh RP, et al. Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology. 2010; 117:1124-1133.
Crossref   Pubmed

4.Brown DM, Michels M, Kaiser PK, et al. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: two-year results of the ANCHOR study. Ophthalmology. 2009; 116:57-65.
Crossref   Pubmed

5.Campochiaro PA, Heier JS, Feiner L, et al. Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology. 2010; 117:1102-1112.
Crossref   Pubmed

6.Cha DM, Kim TW, Heo JW, et al. Comparison of 1-year therapeutic effect of ranibizumab and bevacizumab for myopic choroidal neovascularization: a retrospective, multicenter, comparative study.BMC Ophthalmology. 2014; 14:69.
Crossref   Pubmed

7.Cohen SY, Laroche A, Leguen Y, et al. Etiology of choroidal neovascularization in young patients. Ophthalmology. 1996; 103:1241-1244.
Crossref   Pubmed

8.Cornut PL , Poli M , Feldman A, et al. Intravitreal ranibizumab for choroidal neovascularization secondary to pathological myopia: 12-month results. J Fr Ophtalmology. 2010; 33(5):327-333.
Crossref   Pubmed

9.Heier JS, Brown DM, Chong V et al. Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration. Ophthalmology.2012; 119:2537-2548.
Crossref   Pubmed

10.Heier JS, Clark WL, Boyer DS et al. Intravitreal aflibercept injection for macular edema due to central retinal vein occlusion: two-year results from the COPERNICUS study.  Ophthalmology. 2014; 121:1414-1420.

11.Korobelnik JF, Do DV, Schmidt-Erfurth U, et al. Intravitreal aflibercept for diabetic macular edema. Ophthalmology.2014; 121:2247-2254.

12.Lai TY, Chan WM, Liu DT, et al. Intravitreal ranibizumab for the primary treatment of choroidal neovascularization secondary to pathologic myopia. Retina. 2009; 29:750-756.

13.Mon?s JM, Amselem L, Serrano A, et al. Intravitreal  ranibizumab for choroidal neovascularization secondary to pathologic myopia: 12-month results. Eye (Lond). 2009; 23(6):1275-1280.

14.Nguyen QD, Brown DM, Marcus DM, et al. Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology. 2012; 119:789-801.

15.Ogura Y, Roider J, Korobelnik JF, et al. Intravitreal aflibercept for macular edema secondary to central retinal vein occlusion: 18-month results of the phase 3 GALILEO study. Am J Ophthalmol.2014; 158:1032-1038.

16.Ohno-Matsui K, Yoshida T, Futagami S, et al. Patchy atrophy and lacquer cracks predispose to the development of choroidal neovascularisation in pathological myopia. Br J Ophthalmol.2003;87:570-573.

17.Ozdek S,  Hondur A,  Gurelik G, et al. Transpupillary thermotherapy for myopic choroidal neovascularization: 1-year follow-up International Ophthalmology. 2005; 26(4-5):127-133.

18.Pasyechnikova NV, Naumenko VO, Korol AR, et al. Intravitreal ranibizumab for the treatment of choroidal neovascularizations associated with pathologic myopia: a prospective study. Ophthalmologica. 2015; 233(1):2-7.

19.Pece A, Milani P. Intravitreal aflibercept for myopic choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol. 2016 Dec; 254 (12):2327-32.

20.Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006; 355:1419-1431.

21.Silva RM, Ruiz-Moreno JM, Rosa P, et al. Intravitreal ranibizumab for myopic choroidal neovascularization: 12-month results. Retina. 2010; 30: 407-412.

22.Tufail A, Narendran N, Patel PJ, et al. Ranibizumab in myopic choroidal neovascularization: the 12-month results from the REPAIR study. Ophthalmology. 2013; 120:1944-1945.

23.Tufail A, Patel PJ, Sivaprasad S, et al. Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond).2013; 27:709-715.

24.Virgili G, Menchini F. Laser photocoagulation for choroidal neovascularization in pathologic myopia. Cochrane Database Syst Rev.2005; (4):CD004765.

25.Wolf S, Balciuniene VJ, Laganovska G, et al. RADIANCE: a randomized controlled study of ranibizumab in patients with choroidal neovascularization secondary to pathologic myopia. Ophthalmology.2014;121:682-692.

26.Wu TT, Kung YH. The 12-month outcome of three consecutive monthly intravitreal injections of ranibizumab for myopic choroidal neovascularization. J Ocul Pharmacol Ther. 2012; 28(2):129-133.

27.Yasushi Ikuno, Kyoko Ohno-Matsui, Tien Yin Wong, et al. Intravitreal Aflibercept Injection in Patients with Myopic Choroidal Neovascularization The MYRROR Study. Ophthalmology.2015; 122: 1220-1227.