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Current and emerging treatment options for myopic choroidal neovascularization

Identifieur interne : 000384 ( Ncbi/Merge ); précédent : 000383; suivant : 000385

Current and emerging treatment options for myopic choroidal neovascularization

Auteurs : Leila El Matri [Tunisie] ; Ahmed Chebil [Tunisie] ; Fedra Kort [Tunisie]

Source :

RBID : PMC:4422283

Abstract

Choroidal neovascularization (CNV) is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV), with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for visual outcome. The purpose of this study is to provide an overview of the current treatments for mCNV, including laser, surgical management, verteporfin photodynamic therapy, and mainly anti-vascular endothelial growth factor therapy. Emerging treatment options are also discussed.


Url:
DOI: 10.2147/OPTH.S49437
PubMed: 25987831
PubMed Central: 4422283

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PMC:4422283

Le document en format XML

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</TEI>
<pmc article-type="review-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Clin Ophthalmol</journal-id>
<journal-id journal-id-type="iso-abbrev">Clin Ophthalmol</journal-id>
<journal-id journal-id-type="publisher-id">Clinical Ophthalmology</journal-id>
<journal-title-group>
<journal-title>Clinical Ophthalmology (Auckland, N.Z.)</journal-title>
</journal-title-group>
<issn pub-type="ppub">1177-5467</issn>
<issn pub-type="epub">1177-5483</issn>
<publisher>
<publisher-name>Dove Medical Press</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">25987831</article-id>
<article-id pub-id-type="pmc">4422283</article-id>
<article-id pub-id-type="doi">10.2147/OPTH.S49437</article-id>
<article-id pub-id-type="publisher-id">opth-9-733</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Review</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Current and emerging treatment options for myopic choroidal neovascularization</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>El Matri</surname>
<given-names>Leila</given-names>
</name>
<xref ref-type="aff" rid="af1-opth-9-733"></xref>
<xref ref-type="corresp" rid="c1-opth-9-733"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chebil</surname>
<given-names>Ahmed</given-names>
</name>
<xref ref-type="aff" rid="af1-opth-9-733"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kort</surname>
<given-names>Fedra</given-names>
</name>
<xref ref-type="aff" rid="af1-opth-9-733"></xref>
</contrib>
</contrib-group>
<aff id="af1-opth-9-733">Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Faculty of Medicine of Tunis, University of El Manar, Tunis, Tunisia</aff>
<author-notes>
<corresp id="c1-opth-9-733">Correspondence: Leila El Matri, Boulevard 9 Avril, 1006 Bab Saadoun, Tunis, Tunisia, Tel +216 71 57 36 04, Fax +216 71 57 59 56, Email
<email>leila.elmatri@planet.tn</email>
</corresp>
</author-notes>
<pub-date pub-type="collection">
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>24</day>
<month>4</month>
<year>2015</year>
</pub-date>
<volume>9</volume>
<fpage>733</fpage>
<lpage>744</lpage>
<permissions>
<copyright-statement>© 2015 El Matri et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License</copyright-statement>
<copyright-year>2015</copyright-year>
<license>
<license-p>The full terms of the License are available at
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.</license-p>
</license>
</permissions>
<abstract>
<p>Choroidal neovascularization (CNV) is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV), with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for visual outcome. The purpose of this study is to provide an overview of the current treatments for mCNV, including laser, surgical management, verteporfin photodynamic therapy, and mainly anti-vascular endothelial growth factor therapy. Emerging treatment options are also discussed.</p>
</abstract>
<kwd-group>
<title>Keywords</title>
<kwd>myopia</kwd>
<kwd>choroidal neovascularization</kwd>
<kwd>current treatment</kwd>
<kwd>emerging treatment</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<fig id="f1-opth-9-733" position="float">
<label>Figure 1</label>
<caption>
<p>Development of CRA around the subfoveal CNV treated with IVB injection in the right eye of a 34-year-old woman with a refractive error of −10.0 diopters and axial length of 27.8 mm.</p>
<p>
<bold>Notes:</bold>
(
<bold>A</bold>
) Fundus photograph of the right eye shows small fibrovascular membrane 1 month after IVB; (
<bold>B</bold>
) 1 year after IVB, the right fundus shows a regressed CNV with CRA around; (
<bold>C</bold>
) 3 years after IVB, the right fundus shows a large CRA; (
<bold>D</bold>
) 5 years after IVB, the right fundus shows a larger central area of CRA.</p>
<p>
<bold>Abbreviations:</bold>
CNV, choroidal neovascularization; CRA, chorioretinal atrophy; IVB, intravitreal bevacizumab.</p>
</caption>
<graphic xlink:href="opth-9-733Fig1"></graphic>
</fig>
<table-wrap id="t1-opth-9-733" position="float">
<label>Table 1</label>
<caption>
<p>Summary of published studies on treatment for myopic choroidal neovascularization</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="left" rowspan="1" colspan="1">Study</th>
<th valign="top" align="left" rowspan="1" colspan="1">Number of eyes</th>
<th valign="top" align="left" rowspan="1" colspan="1">Treatment</th>
<th valign="top" align="left" rowspan="1" colspan="1">Follow-up</th>
<th valign="top" align="left" rowspan="1" colspan="1">Main results</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Hamelin et al
<xref rid="b8-opth-9-733" ref-type="bibr">8</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">32</td>
<td valign="top" align="left" rowspan="1" colspan="1">Macular translocation versus surgical removal of CNV</td>
<td valign="top" align="left" rowspan="1" colspan="1">14±15 months</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA was statistically better after macular translocation than after surgical removal</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Fujikado et al
<xref rid="b9-opth-9-733" ref-type="bibr">9</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">11</td>
<td valign="top" align="left" rowspan="1" colspan="1">Foveal translocation with 360-degree retinotomy</td>
<td valign="top" align="left" rowspan="1" colspan="1">6.2 months</td>
<td valign="top" align="left" rowspan="1" colspan="1">Vision improved in eight eyes, was unchanged in two eyes, and worsened in one eye. Seven of 11 eyes (64%) had a final visual acuity of 20/50 or better</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Yamada et al
<xref rid="b10-opth-9-733" ref-type="bibr">10</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">32</td>
<td valign="top" align="left" rowspan="1" colspan="1">Full macular translocation</td>
<td valign="top" align="left" rowspan="1" colspan="1">1 year</td>
<td valign="top" align="left" rowspan="1" colspan="1">The final VA was significantly better in mCNV than in exudative age-related macular degeneration</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Sakimoto et al
<xref rid="b11-opth-9-733" ref-type="bibr">11</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">60</td>
<td valign="top" align="left" rowspan="1" colspan="1">Full macular translocation</td>
<td valign="top" align="left" rowspan="1" colspan="1">5 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA values at 1, 3, and 5 years postoperatively significantly improved (
<italic>P</italic>
<0.001) to 0.54 at 1 year and then remained stable</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Hayashi et al
<xref rid="b14-opth-9-733" ref-type="bibr">14</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">43</td>
<td valign="top" align="left" rowspan="1" colspan="1">PDT</td>
<td valign="top" align="left" rowspan="1" colspan="1">1 year</td>
<td valign="top" align="left" rowspan="1" colspan="1">The BCVA improved by more than two Snellen lines in 16.3%, decreased in 14%, and remained stable in 69.7%</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Verteporfin in photo-dynamic therapy (VIP) study
<xref rid="b12-opth-9-733" ref-type="bibr">12</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">120</td>
<td valign="top" align="left" rowspan="1" colspan="1">PDT</td>
<td valign="top" align="left" rowspan="1" colspan="1">2 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">Stabilization of VA in 72%; there was no statistically significant benefit in the visual outcome at 24 months</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Chen et al
<xref rid="b15-opth-9-733" ref-type="bibr">15</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">33</td>
<td valign="top" align="left" rowspan="1" colspan="1">PDT</td>
<td valign="top" align="left" rowspan="1" colspan="1">2 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">Improvement was much more evident in the younger group, although it was not statistically significant at every follow-up time point</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Hayashi et al
<xref rid="b16-opth-9-733" ref-type="bibr">16</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">46</td>
<td valign="top" align="left" rowspan="1" colspan="1">PDT</td>
<td valign="top" align="left" rowspan="1" colspan="1">4 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">The BCVA did not change significantly</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Coutinho et al
<xref rid="b17-opth-9-733" ref-type="bibr">17</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">43</td>
<td valign="top" align="left" rowspan="1" colspan="1">PDT</td>
<td valign="top" align="left" rowspan="1" colspan="1">5 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">VA stabilized or improved in 65% of the eyes after 24 months, with no significant VA change between month 24 and month 60</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Varano et al
<xref rid="b18-opth-9-733" ref-type="bibr">18</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">19</td>
<td valign="top" align="left" rowspan="1" colspan="1">PDT</td>
<td valign="top" align="left" rowspan="1" colspan="1">10 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">Eyes with subfoveal CNV progressively worsened, while in the eyes with juxtafoveal CNV (63%), BCVA improved</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Yamamoto et al
<xref rid="b23-opth-9-733" ref-type="bibr">23</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">11</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">153 days (range: 35–224)</td>
<td valign="top" align="left" rowspan="1" colspan="1">VA improved by a mean of +3.5 lines (range: −1 to +8 lines)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Sakaguchi et al
<xref rid="b24-opth-9-733" ref-type="bibr">24</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">8</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">3–7 months</td>
<td valign="top" align="left" rowspan="1" colspan="1">The BCVA improved to two or more lines in six eyes (75%) and remained the same in two eyes (25%)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Scupola et al
<xref rid="b31-opth-9-733" ref-type="bibr">31</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">15</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">1 year</td>
<td valign="top" align="left" rowspan="1" colspan="1">The change in BCVA at 1, 6, and 12 months was statistically significant (
<italic>P</italic>
<0.05). Eight eyes (53.3%) had BCVA improved by ≥2 lines at 1-year follow-up; six eyes (40%) had an improvement of ≥3 lines. Seven patients (46.7%) had stable vision 12 months after treatment</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Ruiz-Moreno et al
<xref rid="b34-opth-9-733" ref-type="bibr">34</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">19</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">2 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA gain decreases and was no longer significant by the end of the second year</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Hayashi et al
<xref rid="b40-opth-9-733" ref-type="bibr">40</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">75</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">2 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA in eyes with a subfoveal CNV was not significant. BCVA in eyes with nonsubfoveal CNV was significantly improved</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Voykov et al
<xref rid="b35-opth-9-733" ref-type="bibr">35</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">21</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">2 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">Mean logMAR BCVA improved from 0.64 at baseline to 0.55 after 1 year (
<italic>P</italic>
=0.32) and remained at 0.55 at 2 years (
<italic>P</italic>
=0.23)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Nakanishi et al
<xref rid="b36-opth-9-733" ref-type="bibr">36</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">23</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">2 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA improved after 1 month (
<italic>P</italic>
<0.001); the improvement was maintained at 24 months, (
<italic>P</italic>
<0.005)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Gharbiya et al
<xref rid="b37-opth-9-733" ref-type="bibr">37</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">20</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">2 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA improved significantly (
<italic>P</italic>
<0.05)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Peiretti et al
<xref rid="b41-opth-9-733" ref-type="bibr">41</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">21</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">4 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">71.4% of the eyes demonstrated an improvement of
<bold></bold>
1 line on the Snellen chart, 14.3% showed and 14.3% lost one line</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Oishi et al
<xref rid="b42-opth-9-733" ref-type="bibr">42</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">22</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">4 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA improved after 1, 2, and 3 years. The effect slightly declined to marginally nonsignificant levels after 4 years</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Liang et al
<xref rid="b44-opth-9-733" ref-type="bibr">44</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">9</td>
<td valign="top" align="left" rowspan="1" colspan="1">posterior sub-Tenon injection of bevacizumab</td>
<td valign="top" align="left" rowspan="1" colspan="1">77.56 weeks</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA improved by a mean of −0.38 logMAR (>3 lines)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">El Matri et al
<xref rid="b38-opth-9-733" ref-type="bibr">38</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">80</td>
<td valign="top" align="left" rowspan="1" colspan="1">PDT versus IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">1 year</td>
<td valign="top" align="left" rowspan="1" colspan="1">In the IVB group, BCVA was significantly better at 3 months and 6 months than at baseline, but not at 12 months; in the PDT group, mean BCVA was positively improved at 3 months and 6 months, which was not significantly different from that at baseline, then decreased at 12 months</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Baba et al
<xref rid="b32-opth-9-733" ref-type="bibr">32</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">24</td>
<td valign="top" align="left" rowspan="1" colspan="1">PDT versus IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">2 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">The BCVA did not change after PDT but was significantly improved after IVB</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Ikuno et al
<xref rid="b32-opth-9-733" ref-type="bibr">32</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">30</td>
<td valign="top" align="left" rowspan="1" colspan="1">PDT versus IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">2 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB provides a significantly better BCVA than PDT for mCNV over the long term</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Parodi et al
<xref rid="b6-opth-9-733" ref-type="bibr">6</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">54</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB versus PDT versus laser</td>
<td valign="top" align="left" rowspan="1" colspan="1">2 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB offers the best functional results during a 2-year follow-up</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Silva et al
<xref rid="b45-opth-9-733" ref-type="bibr">45</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">26</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR</td>
<td valign="top" align="left" rowspan="1" colspan="1">6 months</td>
<td valign="top" align="left" rowspan="1" colspan="1">VA improved significantly at 1 month, 3 months, and 6 months</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Tufail et al
<xref rid="b50-opth-9-733" ref-type="bibr">50</xref>
<break></break>
(REPAIR)</td>
<td valign="top" align="left" rowspan="1" colspan="1">65</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR</td>
<td valign="top" align="left" rowspan="1" colspan="1">1 year</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA improved after 1 year</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Lai et al
<xref rid="b46-opth-9-733" ref-type="bibr">46</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">16</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR</td>
<td valign="top" align="left" rowspan="1" colspan="1">1 year</td>
<td valign="top" align="left" rowspan="1" colspan="1">At 1 month and 12 months, the mean BCVA improved significantly</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Silva et al
<xref rid="b47-opth-9-733" ref-type="bibr">47</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">34</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR</td>
<td valign="top" align="left" rowspan="1" colspan="1">1 year</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA improved to 12-month follow-up, and the difference was statistically significant</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Calvo-Gonzalez et al
<xref rid="b39-opth-9-733" ref-type="bibr">39</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">67</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR</td>
<td valign="top" align="left" rowspan="1" colspan="1">15.9 months</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA improved by 7.8 letters after the first injection, 12.5 letters after three injections, and 12 letters by end of follow-up</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Vadala et al
<xref rid="b48-opth-9-733" ref-type="bibr">48</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">40</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR</td>
<td valign="top" align="left" rowspan="1" colspan="1">18 months</td>
<td valign="top" align="left" rowspan="1" colspan="1">Mean final VA improved in 82.5% of patients</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Franqueira et al
<xref rid="b53-opth-9-733" ref-type="bibr">53</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">40</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR</td>
<td valign="top" align="left" rowspan="1" colspan="1">3 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">High proportion of patients gaining or stabilizing BCVA at a 3-year follow-up</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Freitas-da-Costa et al
<xref rid="b56-opth-9-733" ref-type="bibr">56</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">67</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR</td>
<td valign="top" align="left" rowspan="1" colspan="1">5 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">BCVA was significant at 2 years, and this gain remained significantly stable for 5 years</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Wolf et al
<xref rid="b49-opth-9-733" ref-type="bibr">49</xref>
<break></break>
(RADIANCE)</td>
<td valign="top" align="left" rowspan="1" colspan="1">277</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR versus PDT</td>
<td valign="top" align="left" rowspan="1" colspan="1">1 year</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR provided superior BCVA gains versus PDT up to month 3. Over 12 months, individualized ranibizumab treatment was effective in improving and sustaining BCVA</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Iacono et al
<xref rid="b53-opth-9-733" ref-type="bibr">53</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">55</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB versus IVR</td>
<td valign="top" align="left" rowspan="1" colspan="1">18 months</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVR achieved greater efficacy than IVB and the IVR subgroup achieved a faster central macular thickness</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Ruiz-Moreno et al
<xref rid="b55-opth-9-733" ref-type="bibr">55</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">92</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB versus IVR</td>
<td valign="top" align="left" rowspan="1" colspan="1">4 years</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVB and IVR are effective therapies and show similar clinical effects; VA gain is maintained at 4-year follow-up</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Rinaldi et al
<xref rid="b58-opth-9-733" ref-type="bibr">58</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">20</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVP</td>
<td valign="top" align="left" rowspan="1" colspan="1">48 weeks</td>
<td valign="top" align="left" rowspan="1" colspan="1">After IVP, a significant decrease in foveal thickness occurred and at the end of follow-up, CNV closure was obtained in all eyes. An improvement of functional parameters was recorded in all patients</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Kitagawa et al
<xref rid="b59-opth-9-733" ref-type="bibr">59</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">31</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVP</td>
<td valign="top" align="left" rowspan="1" colspan="1">1 year</td>
<td valign="top" align="left" rowspan="1" colspan="1">VA and retinal sensitivity were maintained, while metamorphopsia was improved 1 year after IVP</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Kitagawa et al
<xref rid="b60-opth-9-733" ref-type="bibr">60</xref>
</td>
<td valign="top" align="left" rowspan="1" colspan="1">28</td>
<td valign="top" align="left" rowspan="1" colspan="1">IVP versus IVB</td>
<td valign="top" align="left" rowspan="1" colspan="1">1 year</td>
<td valign="top" align="left" rowspan="1" colspan="1">Changes in VA at 1 year did not differ significantly between IVB and IVP; IVB improved mean retinal sensitivity with fewer injections than IVP</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn1-opth-9-733">
<p>
<bold>Abbreviations:</bold>
BCVA, best-corrected visual acuity; CNV, choroidal neovascularization; IVB, intravitreal bevacizumab; IVP, intravitreal pegaptanib; IVR, intravitreal ranibizumab; logMAR, logarithm of the minimum angle of resolution; mCNV, myopic choroidal neovascularization; PDT, photodynamic therapy; REPAIR, Ranibizumab for treatment of CNV secondary to Pathological myopia: An individualized Regimen; VA, visual acuity.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Tunisie</li>
</country>
<region>
<li>Gouvernorat de Tunis</li>
</region>
<settlement>
<li>Tunis</li>
</settlement>
<orgName>
<li>Université de Tunis - El Manar</li>
</orgName>
</list>
<tree>
<country name="Tunisie">
<region name="Gouvernorat de Tunis">
<name sortKey="El Matri, Leila" sort="El Matri, Leila" uniqKey="El Matri L" first="Leila" last="El Matri">Leila El Matri</name>
</region>
<name sortKey="Chebil, Ahmed" sort="Chebil, Ahmed" uniqKey="Chebil A" first="Ahmed" last="Chebil">Ahmed Chebil</name>
<name sortKey="Kort, Fedra" sort="Kort, Fedra" uniqKey="Kort F" first="Fedra" last="Kort">Fedra Kort</name>
</country>
</tree>
</affiliations>
</record>

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