Treatment Patterns for Choroidal Neovascularization
Ophthalmology, July 2017
Willis et al. used data from the IRIS Registry to characterize treatment patterns and outcomes for patients with myopic choroidal neovascularization (mCNV) in the United States. They found that the most common treatment for mCNV was injections of anti–vascular endothelial growth factor (VEGF) drugs, and that one-fourth of patients who received no treatment experienced a decline in vision.
This retrospective cohort study included 185 adults with treatment-naïve mCNV (in at least 1 eye) who were seen in clinics participating in the Academy’s IRIS Registry during a 3-year period. The type of initial treatment for mCNV (within 365 days of diagnosis) was categorized as either observation, intravitreal anti-VEGF injection, verteporfin photodynamic therapy (vPDT), or laser photocoagulation. The difference in visual acuity between the diagnosis date and 1 year afterward was documented. For that same 1-year period, the frequency of anti-VEGF injection per treated eye was estimated.
Active treatment within 1 year of diagnosis was reported for 73% of the patients (n = 135); all other patients were observed (n = 50). Of those treated actively, 134 (99%) received anti-VEGF injections, and 1 underwent vPDT. The mean number of anti-VEGF injections per affected eye during the year following diagnosis was 2.8. In addition, anti-VEGF treatment was associated with significant improvement in visual acuity by 1 year of therapy (mean logMAR improvement, 0.17 units; 95% confidence interval [CI], 0.12-0.20; p < .01). Eyes that were not treated during the first year showed significant visual decline (mean logMAR decline, 0.03 units; 95% CI, 0.008-0.05; p < .01).
In conclusion, the most common treatment for mCNV in the United States is intravitreal injections of anti-VEGF medications. This strategy is highly effective for improving visual acuity, and many untreated patients experience visual decline. Additional studies are warranted to understand the barriers to delivering anti-VEGF therapy to patients with mCNV.
The original article can be found here.