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  • Treatment Patterns for Choroidal Neovascularization

    By Lynda Seminara and selected by Stephen D. McLeod, MD
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    Journal Highlights

    Ophthalmology, July 2017

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    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.