Long-term functional and morphologic retinal changes after ranibizumab and photodynamic therapy in myopic choroidal neovascularization

Purpose: To assess and compare the long-term functional and anatomical outcomes in eyes with myopic choroidal neovascularization (CNV) treated with intravitreal injections of ranibizumab or with photodynamic therapy (PDT). Methods: Eighty-five eyes of 85 consecutive patients with myopic CNV and treated with either PDT (43/85) or ranibizumab 0.5 mg (42/85) and at least 24 months of follow-up were collected. Data from the best-corrected visual acuity, optical coherence tomography, and fluorescein angiography were compared between the groups. Differences in the regression pattern of myopic CNV and the rate of chorioretinal atrophy development were also compared between the groups. Results: The effect of treatment over time on best-corrected visual acuity and the central retinal thickness was significantly greater in the ranibizumab group (P = 0.0012 and P , 0.0002, respectively), with eyes treated with ranibizumab showing a significant central retinal thickness decrease since the first visit and maintained until 24 months. The proportion of patients showing a complete closure of CNV was similar between the groups (93% [39 of 42 eyes in the ranibizumab group] vs. 88% [38 of 43 eyes in the PDT group], P = 0.48). Both treatments were associated with an increase of chorioretinal atrophy size, which was greater in the PDT-treated eyes (P = 0.016). Conclusion: Ranibizumab therapy showed a greater long-term efficacy compared with PDT in myopic CNV eyes, with a fewer proportion of eyes developing an increase of lesion and chorioretinal atrophy size.