Intravitreal anti-VEGF versus photodynamic therapy with verteporfin for treatment of myopic choroidal neovascularization

Abstract

Purpose: The purpose of this study was to compare visual outcomes after treatment with intravitreal antivascular endothelial growth factor (anti-VEGF) injection or photodynamic therapy (PDT) in patients with myopic choroidal neovascularization (CNV).

Methods: One hundred and forty-two eyes of 128 consecutive patients treated with anti-VEGF (ranibizumab or bevacizumab) and/or PDT for myopic choroidal neovascularization were retrospectively reviewed. Patients were categorized into 3 groups: PDT (51 eyes), anti-VEGF (63 eyes), and a combination group (PDT with anti-VEGF) (28 eyes). Corrected visual acuity values at baseline and 3, 6, 9, and 12 months after treatment were compared.

Results: The anti-VEGF group showed significant postoperative improvement in visual acuity compared with the PDT and combination groups (P = 0.01 and 0.04, respectively). The anti-VEGF group demonstrated visual improvement from baseline at every follow-up visit after treatment (P = 0.04, 0.02, 0.01, and 0.002, respectively). The anti-VEGF group showed visual improvement (Snellen equivalent) from 0.57 logarithm of the minimum angle of resolution (0.27) to 0.33 logarithm of the minimum angle of resolution (0.47) (P = 0.01). Furthermore, 98.4% of patients in the anti-VEGF group and 92.8% of those in the combination group lost <15 letters from baseline visual acuity compared with 72.6% in the PDT group (P = 0.001 and 0.02, respectively). In the anti-VEGF group, 39.7% of patients improved from baseline by 15 or more letters compared with 17.7% in the PDT group (P = 0.02) and 21.4% in the combination group (P = 0.07).

Conclusion: Intravitreal anti-VEGF injection is superior to PDT alone or a combination of PDT with anti-VEGF for treating myopic choroidal neovascularization.