Prognostic factors for visual outcome after intravitreal anti-VEGF injection for naive myopic choroidal neovascularization

PURPOSE: The aim of this study was to evaluate the prognostic factors of visual outcome after intravitreal anti-vascular endothelial growth factor injection in patients with myopic choroidal neovascularization (CNV). METHODS: Forty eyes of 40 consecutive patients with myopic CNV who had received intravitreal ranibizumab or bevacizumab injections were retrospectively reviewed. Baseline visual acuity, presence of lacquer crack, dark rim, peripapillary choroidal atrophy size, and location of myopic CNV were evaluated using fluorescein angiography and indocyanine green angiography. RESULTS: The logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) at 12 months after treatment was 0.23 ± 0.28, and there was a significant improvement compared with the baseline BCVA (P = 0.001). After multiple linear regression analysis, baseline BCVA, presence of lacquer crack extending the fovea, and peripapillary choroidal atrophy size were the factors that significantly correlated with BCVA at 12 months (P = 0.001, P = 0.04, and P = 0.04). For mean change in BCVA over 12 months, there were also significant correlations with baseline BCVA, lacquer crack extension to the fovea, and peripapillary choroidal atrophy size (P = 0.001, P = 0.03, and P = 0.03). The mean number of anti-vascular endothelial growth factor injections was 2.8 ± 2.0 over 12 months. Complete resolution of myopic CNV was noted in 22 eyes (55.0%) after initial first injection, and no additional treatment was required in 12 eyes (30%). CONCLUSION: Better baseline BCVA, lacquer crack extension to the fovea, and peripapillary atrophy were negative prognostic factors of visual acuity improvement, and there was quite a promising result of anti-vascular endothelial growth factor treatment in patients with myopic CNV.ope