Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 26.
doi: 10.1007/s00417-025-06973-9. Online ahead of print.

Myopic macular neovascularization treatment: A 2-year follow-up of a real-life cohort

Assaf Hilely #  1 , Roee Arnon #  2 , Reut Shor  1 , Ori Segal  3 , Justin Lerann Shad  4 , Eran Greenbaum  3 , Omer Trivizki  1 , Anat Loewenstein  1 , Gilad Rabina  5
Affiliations

Myopic macular neovascularization treatment: A 2-year follow-up of a real-life cohort

Assaf Hilely et al. Graefes Arch Clin Exp Ophthalmol. .

Abstract

Purpose: Evaluating the impact for different number of Anti-vascular endothelial growth Factor (VEGF) injections on macular neovascularization (MNV) secondary to pathological myopia, during a 2-year follow-up period, in relation to visual outcome.

Methods: This was a multicenter, retrospective study of patients with myopic MNV (mMNV) for 24 months.

Results: A total of 55 patients with mMNV, with a mean age of 65.7 ± 14.5 years, met the inclusion criteria. The mean number of injections was significantly higher during the first year of follow-up with 8.78 ± 2.90 within the 1st year versus 3.45 ± 4.40 during the 2nd year (p = 0.037). Visual acuity (VA) remained relatively stable throughout the follow-up (p = 0.902), with most patients maintaining their vision or experiencing a loss of up to 5 Snellen letters. (42 patients, 76.3%, p < 0.001).

Conclusion: During a 24-month period, there was a lack of BCVA improvement, which may be attributed to the PRN injection regimen and the relatively low number of injections administered for mMNV. These findings suggest that mMNV may be undertreated in routine practice, with suboptimal intravitreal injection frequency.

Key messages: What is known The PRN injection regimen is widely used for treating myopic macular neovascularization (mMNV) due to its less aggressive nature and the potential risks of retinal break, retinal detachment, and other complications in highly myopic eyes. What is new At the 24-month follow-up, patients with mMNV treated with anti-VEGF agents in a PRN regimen showed no significant improvement in BCVA. Myopic MNV may be fallacy thought of as a less aggressive pathology and therefore is undertreated and perhaps may require a much more intensive injection schedule.

Keywords: Anti-vascular endothelial growth factor; Macular neovascularization; Myopia; Myopic choroidal neovascularization; Pro-re-nata.

PubMed Disclaimer

Conflict of interest statement

Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board (IRB) of Meir Medical Center, Kfar Saba and Tel Aviv Sourasky Medical Center, Tel Aviv, Israel and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Conflict of interest: No Conflicts of Interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

References

    1. Nguyen QD, Shah S, Tatlipinar S, Do DV, Anden EV, Campochiaro PA (2005) Bevacizumab suppresses choroidal neovascularisation caused by pathological myopia. Br J Ophthalmol 89:1368. https://doi.org/10.1136/bjo.2005.066431 - DOI - PubMed - PMC
    1. Zhu Y, Zhang T, Xu G, Peng L (2016) Anti-vascular endothelial growth factor for choroidal neovascularisation in people with pathological myopia. Cochrane Database Syst Rev 12. https://doi.org/10.1002/14651858.CD011160.PUB2
    1. Ruiz-Moreno JM, López-Gálvez MI, Montero Moreno JA, Pastor Jimeno JC (2013) Intravitreal bevacizumab in myopic neovascular membranes: 24-month results. Ophthalmology. https://doi.org/10.1016/j.ophtha.2013.03.006 - DOI - PubMed
    1. Swaminathan S, Mahmoudzadeh R, Wakabayashi T, Bowers M, Momenaei B, Abishek RM (2024) Outcomes of pro re nata versus treat-and-extend anti-vascular endothelial growth factor injections for myopic macular neovascularization in multiethnic patients in the United States. Retina. https://doi.org/10.1097/IAE.0000000000004256 - DOI - PubMed
    1. Wu TT, Kung YH (2012) The 12-month outcome of three consecutive monthly intravitreal injections of ranibizumab for myopic choroidal neovascularization. J Ocul Pharmacol Ther 28:129. https://doi.org/10.1089/JOP.2011.0106 - DOI - PubMed - PMC

LinkOut - more resources