Intravitreal Bevacizumab for Extrafoveal Choroidal Neovascularization Associated With Pathologic Myopia: 24-Month Outcomes

Purpose To evaluate the long-term efficacy and safety of intravitreal bevacizumab injection (IVBI) for the treatment of extrafoveal choroidal neovascularization (CNV) secondary to pathologic myopia. Methods The design of the study was an open-label prospective nonrandomized interventional case series. Seven eyes from 7 patients with extrafoveal CNV secondary to pathologic myopia were recruited. All patients underwent a complete ophthalmologic examination,including ETDRS visual acuity, optical coherence tomography, and fluorescein angiography. The protocol required 3 monthly consecutive IVBI (1,25 mg), followed by repeat injections on the basis of OCT parameters and angiographic features over the 24-month follow-up. Results Three eyes underwent previous photodynamic therapy, whereas the remaining 4 eyes were naive. All patients completed follow-up at 24 months. The mean baseline best corrected visual acuity was 0.6 logMAR, which improved to 0.43 logMAR at 24 months (p<0.05). Four eyes (57.14%) showed a functional improvement of at least 1 line. One eye (14.28%) showed a functional deterioration of at least 1 line, whereas no visual change was registered in 2 eyes (28.57%). The mean central macular thickness (CMT) at baseline was 295 microns and reduced to 289 microns at 24 months, with no statistically significant difference. No side effect or complication was registered over the follow-up. Conclusions This prospective investigation shows that IVBI lead to a BCVA improvement in more than 50% of eyes with extrafoveal CNV secondary to pathologic myopia over a 24-month follow-up.