Ten-year outcomes of intravitreal injection of ranibizumab for the treatment of myopic choroidal neovascularization

This study aimed to evaluate the 10-year outcomes and efficacy of intravitreal injection (IVI) of ranibizumab for treatment of myopic choroidal neovascularization (CNV). This retrospective study included 12 consecutive eyes with myopic CNV treated with ranibizumab with a minimum follow-up of 10 years. The primary outcome was the mean change in best corrected visual acuity (BCVA). The secondary outcomes were Snellen line visual acuity distribution, number of IVIs, and changes in areas of chorioretinal patchy atrophy. The mean number of IVIs was 4.92 ± 5.93 (range, 1-23). The mean BCVA at baseline was 0.49 ± 0.54 logMAR; it improved to 0.29 ± 0.38(P = .017), 0.40 ± 0.39(P = .186), 0.32 ± 0.41 (P = .087), 0.49 ± 0.40 (P = .643), 0.45 ± 0.51 (P = .817) logMAR at 1, 3, 5, 6, and 10 years, respectively. At baseline and 10 years, 8.3% of eyes had a BCVA of 6/60 or worse, and 58.33% and 50% of eyes had a BCVA of 6/12 or better, respectively. The 3-month loading protocol was significantly associated with a Snellen visual acuity gain of >3 lines at 5 years (P = .035); however, the association was lost at 10 years (P = .371). Patchy atrophy increased in 5 eyes (41.67%) after 10 years. Intravitreal ranibizumab injections provided favorable and safe 10-year visual outcomes for myopic CNV. These results are notably superior to the 10-year natural history previously reported in Japanese patients, suggesting that long-term anti-VEGF therapy can effectively preserve vision in this population.