Fundus Autofluorescence Changes After Ranibizumab Treatment for Subfoveal Choroidal Neovascularization Secondary to Pathologic Myopia

Am J Ophthalmol. 2015 Aug;160(2):322-327.e2. doi: 10.1016/j.ajo.2015.04.030. Epub 2015 Apr 30.

Abstract

Purpose: To describe fundus autofluorescence (FAF) patterns of myopic choroidal neovascularization (CNV) treated with intravitreal ranibizumab and their correlation with visual acuity.

Design: Prospective interventional case series.

Methods: Twenty-seven eyes (27 patients) affected by myopic CNV were enrolled from January 2011 to January 2013. All patients underwent a complete ophthalmologic examination, including best-corrected visual acuity (BCVA) determination and fundus autofluorescence (FAF). The patients underwent ranibizumab injections following a pro re nata treatment regimen. The main outcome measure was the identification of the FAF patterns of myopic CNV over a 12-month follow-up. The secondary outcome was the correlation of the FAF patterns with the BCVA.

Results: At baseline 17 eyes (63%) showed a hyperautofluorescent pattern and 10 eyes (37%) a patchy pattern. BCVA changed from 0.48 ± 0.23 (logMAR) to 0.30 ± 0.32 at the 12-month examination (P = .027) in the hyper-FAF subgroup. In the subgroup showing the patchy pattern, the BCVA declined slightly from 0.51 ± 0.27 to 0.56 ± 0.37 (P = .53). The 14 eyes preserving the hyper-FAF pattern during the follow-up had a final BCVA of 0.20 ± 0.17, whereas the 9 eyes maintaining the patchy pattern showed a final BCVA of 0.60 ± 0.37 (P = .002). The atrophic area of the retinal pigment epithelium assessed on the basis of FAF increased from 1.27 ± 2.80 mm(2) to 1.83 ± 3.74 mm(2) at the 12-month examination (P = .016). The mean atrophic area increased by 0.37 mm(2) in the hyper-FAF subgroup and by 0.90 mm(2) in the patchy FAF subgroup.

Conclusions: Two main patterns were identified on FAF in myopic CNV and were related to the prognostic evolution, the hyperautofluorescent CNV being associated with a greater visual gain and fewer atrophic changes over a 12-month follow-up.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Choroid / drug effects
  • Choroid / pathology
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / etiology
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications*
  • Myopia, Degenerative / diagnosis
  • Prognosis
  • Prospective Studies
  • Ranibizumab
  • Retinal Pigment Epithelium / drug effects
  • Retinal Pigment Epithelium / pathology*
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity

Substances

  • Antibodies, Monoclonal, Humanized
  • Ranibizumab