Two-Year Visual Results for Older Asian Women Treated With Photodynamic Therapy or Bevacizumab for Myopic Choroidal Neovascularization

Purpose

To compare the long-term visual and anatomic outcome of treatment with photodynamic therapy (PDT) or intravitreal bevacizumab (IVB; Avastin; Genentech Inc, South San Francisco, California, USA) for choroidal neovascularization attributable to pathologic myopia (mCNV).

Design

An open-label, interventional case series.

Methods

setting: Multi-institutional. patients: Thirty-one eyes of Japanese women who received either PDT or IVB for mCNV. Inclusion criteria were age 50 years or older, greatest linear dimension (GLD) 1200 to 3000 μm, and baseline best-corrected visual acuity (BCVA) 20/200 to 20/40. intervention procedures: Patients received either PDT or IVB (1 mg/40 μL) throughout the study, with re-treatment when necessary. main outcome measures: BCVA and visual gain/loss at 3, 6, 12, 18, and 24 months after the initial treatment.

Results

Age, BCVA, location of CNV, refractive error, and symptom duration at baseline did not differ significantly between groups. BCVA was significantly improved at 3 to 12 months (P < .05); however, the significance was lost at 18 and 24 months in the IVB group. The PDT group showed no significant improvement within the first year, and vision slowly worsened after 12 months, becoming significantly worse at 18 and 24 months compared to baseline (P< .01). BCVA was significantly higher in the IVB group at 6 months (P< .05), and 12 months or further (P < .01). Visual gain was significantly greater in the IVB group at 6, 12, 18, and 24 months (P < .05 for 6, 18, and 24 months and P < .01 for 12 months).

Conclusions

These findings indicate that the effects of PDT and IVB have a different time course, and that IVB provides a significantly better BCVA than PDT for mCNV over the long-term.