Intravitreal aflibercept for the treatment of choroidal neovascularization associated with pathologic myopia: a pilot study

Andrii R Korol, Oleg S Zadorozhnyy, Volodymyr O Naumenko, Taras B Kustryn, Nataliya V Pasyechnikova, Andrii R Korol, Oleg S Zadorozhnyy, Volodymyr O Naumenko, Taras B Kustryn, Nataliya V Pasyechnikova

Abstract

Purpose: To determine the efficacy of intravitreal aflibercept injections for the treatment of patients with choroidal neovascularization (CNV) associated with pathologic myopia.

Methods: In this uncontrolled, prospective cohort study, 31 eyes of 30 consecutive patients affected by CNV associated with pathologic myopia were treated with intravitreal aflibercept (2 mg) as needed following two initial monthly doses and observed over a 12-month follow-up period. The primary endpoint was change in best-corrected visual acuity (BCVA) at month 12, while central retinal thickness (CRT) on optical coherence tomography (OCT), neovascularization activity on fluorescein angiography, the number of aflibercept injections administered, and safety were examined as secondary endpoints.

Results: Patients received a mean of 2.6 intravitreal aflibercept injections over the 12-month study period. Compared with baseline, BCVA improved significantly at all time points (P<0.05). Mean (standard deviation [SD]) decimal BCVA was 0.2 (0.1) at baseline and 0.35 (0.16) at month 12. The greatest improvement in BCVA was seen within the first 2 months (P=0.01). Mean (SD) CRT on OCT decreased from 285 (62) µm at baseline to 227 (42) µm (P=0.01) at month 12. There was a continuous decrease in mean CRT on OCT over time. No cases of endophthalmitis, uveitis, stroke, or retinal detachment were noted. No patient demonstrated an intraocular pressure >20 mmHg during any study visit.

Conclusion: The 12-month results of intravitreal aflibercept for myopic CNV using an as-needed regimen were positive, showing benefits in visual and anatomic outcomes and an acceptable tolerability profile.

Keywords: aflibercept; angiogenesis inhibitors; choroidal neovascularization; eye diseases; pathologic myopia.

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Change in mean BCVA following treatment with intravitreal aflibercept for myopic choroidal neovascularization. Abbreviation: BCVA, best-corrected visual acuity.
Figure 2
Figure 2
Change in mean retinal thickness after treatment with intravitreal aflibercept for myopic choroidal neovascularization.
Figure 3
Figure 3
(A) Fundus photograph showing the CNV before treatment. (B) Fundus photograph of the same patient showing CNV after treatment. (C) FA in the late phase (15 min) showing staining and leakage from the CNV before injection. (D) FA in the late phase (15 min) showing decreased staining and leakage from the CNV after two injections. (E) OCT image showing increased retinal reflectivity and a hyper-reflective round lesion under the retina corresponding to the CNV before treatment. (F) OCT image after two intravitreal injections showing decreased retinal thickness in foveal. Abbreviations: CNV, choroidal neovascularization; FA, fluorescein angiography; OCT, optical coherence tomography.

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