Treatment of choroidal neovascularisation in highly myopic eyes

Background: The aim of this study was to examine the effectiveness (visual outcome) of photodynamic therapy with verteporfin (PDT) and intravitreal anti-VEGF therapy for the treatment of choroidal neovascularisation secondary to pathologic myopia. Methods: A retrospective study of choroidal neovascularisation in highly myopic patients was undertaken at the Eye Hospital Ljubljana (from 2004 to 2010). The main outcome measures were: spherical equivalent, age at onset of CNV, composition and location of CNV, visual acuity before treatment, treatment type (PDT, intravitreal anti-VEGF injections, combination of both treatments), visual acuity after treatment and treatment-related complications. Results: Fifty-nine eyes of 59 patients (7 men and 52 women) with myopic CNV were enrolled in the study. The mean age of the patients was 59.7 (range 26-83) years and the spherical equivalent refractive error was - 10.2 D (range - 6.0 D to - 20.0 D). Twenty-four eyes were treated with PDT, 9 with PDT and anti-VEGF, and 26 eyes with anti-VEGF injections alone. The followup period was 21.5 months (range 6 months-6 years). The patients treated with anti-VEGF injections had a better final best-corrected visual acuity than PDT treated patients. No systemic side effects were noted. Conclusions: Intravitreal anti-VEGF injections are an effective therapy for sub- and juxtafoveal myopic CNV.