Barbara Parolini, Grazia Pertile (Verona, Italy)

Advantages:

The results of our study would advise an on-demand intravitreal injection of bevacizumab (IVB) for juxtafoveal and a monthly scheme for subfoveal myopic choroidal neovascularization (CNV).

Methods:

We retrospectively analyzed the charts of 45 patients with myopic CNV treated with IVB between March 2006 and December 2008, with BCVA, biomicroscopy, color fundus photography, Optical Coherence Tomography (OCT) with the Stratus OCT (Carl Zeiss Meditec), and with the Spectralis OCT (Heidelberg). Eyes were followed up for 2 years.

Effectiveness / Safety:

We identified 2 subgroups, based on the CNV location at baseline: the JUXTA-CNVS group, constituted by 17 juxtafoveal lesions (37.78%) and the SUB-CNVS group constituted by 28 subfoveal (62.22%) lesions. The percentage of naïve CNV in the 2 subgroups was not statistically significant. SUB-CNVs are larger than JUXTA-CNVs at baseline. If we express the decrease in the CNV size as a percentage of the area at baseline, the JUXTA-CNVS diminished by 26,7%, and the SUB-CNVS by 19.41%. Hence, the mean area of the CNVs shows a greater reduction relatively to their initial dimensions in the JUXTA-CNVS. The maintenance of the size of a juxtafoveal lesion is extremely important since it prevents the lesion to invade the subfoveal zone. In our study, only 1 of 17 lesions of the JUXTA-CNVS (5,8%) turned into subfoveal during the follow-up. After 2 years, we observed a mean increase in BCVA of 2 lines in the JUXTA-foveal group, and of 1 line in the SUB-foveal group. JUXTA-CNVSs respond to 1 IVB in 65% of cases, while SUB-CNV respond to 1 injection only in 25% of the cases. It would seem reasonable to advise an on-demand approach for juxtafoveal and a monthly injection scheme for subfoveal CNVs.