Clinical Evaluation Of Intravitreal Lucentis Injection Or Photodynamic Therapy For Choroidal Neovascularization Due To Pathologic Myopia

ObjectiveTo observe therapeutic superiority of ranibizumab0.5mg Monotherapy orphotodynamic therapy(PDT) for choroidal neovascularization (CNV) due topathologic myopia(PM)MethodsWe include40patients with subfoveal CNV caused by pathologic myopia.patients were randomized to ranibizumab (lucentis)(n=20), photodynamic therapy(PDT)(n=20). ranibizumab (lucentis) was given once a month.Verteporfin PDT wasperformed using the recommended standard． All patients were followedclinically and with fundus flourescein angiography (FFA)and optical coherencetom ography(OCT) at baseline and1month，3，6months after treatment． Thebest-corrected visual acuity (BCVA) was measured every month and the OCTfindings were examined before and1month，3，6months after treatment． The BCVAlevels were converted to logM AR equivalents．Results1．Both lucentis and PDT can improve patients BCVA, Lucentis was superior tophotodynamic therapy(PDT) in improving BCVA from month2through6(P=0.0368>0,05)In lucentis group，the mean BCVA (logMAR)was0.92±0.47before treatment0．56±0．03at the last visit (P＜0．01)．The BCVA improved m ore than4lines in8eyes (40%)，im proved2-3lines in6eyes(30%) and im proved1line stabilized(no change) in6eyes(30%) and none decreased．In photodynamic therapy(PDT) group， the mean BCVA (logMAR)was0.96±0.25before treatm ent and0.79±0.12at the last visit (P＜0.05)． The BCVAimproved more than4lines in4eyes (20%)，improved2-3lines in6eyes(30%) and improved1line stabilized (no change) in8eyes (40%) anddecreased in2eyes (10%) 2. The mean central macular thickness was significantly reduced from baselinewith Lucentis and PDT，both (P＜0.05).PDT was superior Lucentis from baseline to month1through month2，（P＜0.05）no statistical differences were detected between them in month3；in the lastvisit，PDT was superior Lucentis3. The qualitmive detection of fluid leakage by Fundus fluorescein angiography：the number of patient of fluorescence leakage was significantly reduced from baselinewith Lucentis(reduced100％)and PDT(reduced80％), Lucentis was superior tophotodynamic therapy(PDT)4.No complication occurred． monotherapy was not associated with anincreasedrisk of cardiovascular or cerebrovascular events in this study．Conclusions：1. Lucentis or PDT for CNV caused by PM was effecetive with an significantlyimprovement in BCVA， FFA and OCT. Lucentis was superior to photodynamictherapy(PDT)2. Lucentis intravitreal injection can be regarded as the first choice for CNVcaused by PM3. Lucentis monotherapy or photodynamic therapy(PDT) had a safety profile inCNV caused by PM...