Clinical Observation Of Intravitreal Ranibizumab Injection For Choroidal Neovascularization (CNV) In Degenerative Myopia

ObjectiveThe purpose of this research is to evaluate the clinical efficacy and safety ofintravitreal injection of ranibizumab for choroidal neovascularization (CNV) indegenerative myopia, and provide effective method for the clinical treatment ofdegenerative myopia with macular CNV.Materials and methods34consecutive patients (36eyes) of degenerative myopia with macular CNVwere observed, from September2012to August2013at section one ofophthalmology of the First Affiliated Hospital of Zhengzhou University, whoconfirmed by optical coherence tomography (OCT) and fluorescein angiography(FFA), and exclude other eye diseases which associated with the visual function orhad intraocular surgery or had undergone other treatment or caused by other reasons of macular CNV. All patients were performed with intravitreal ranibizumab0.5mg(0.05ml), all patients were received one-month follow-up after the injection, andadded injections at the time of follow-up as needed. The best-corrected vision,slit-lamp microscopy, non-contact tonometry, ophthalmoscopy, fundus photography,OCT and FFA examination were recorded before and after operation, the follow-uptime was6months. The best-corrected visual acuity, retinal nerve fiber layer (RNFL)were analyzed before and after treatment. This study obtained the approval of theFirst Affiliated Hospital of Zhengzhou University Ethics Committee, all patientsunderstood treatment, received treatment and signed informed consent.The results were analyzed with SPSS17.0software. Best corrected visual acuityvalues were converted to logMAR values. All the quantitative datas were used asmean±standard deviation and measured by Kruskal-Wallis test, with P <0.05wasconsidered statistically significant; the two groups were compared by Bonferronimethod, with P <0.0083was considered statistically significant.ResultsVisual acuity improved in17eyes(47.22%) at the time of6months follow-up,16eyes (44.44%) got vision stable,3eyes (8.33%) caused vision loss because ofbleeding again. The mean logMAR visual acuity was1.01±0.51before treatment,and after a month was0.92±0.46, after3months was0.75±0.41, after6monthswas0.73±0.40, the difference was statistically significant (HC=8.46, P <0.05). TheCMT decreased from (315.94±16.89) μm at baseline to (302.83±19.95) μm aftera month, after3months was (294.81±25.31) μm, after6months was (292.19±20.24)μm, the difference was statistically significant (HC=20.22, P <0.05). The fluoresceinleakage of CNV disappeared in22eyes, ceased in13eyes, and1eye was found freshbleeding. Conclusions1Intravitreal injection of ranibizumab can relieve macular edema and improvethe vision. It is an effective methods for the treatment of CNV associated withdegenerative myopia.2VEGF factor may play a certain role in the developing progress ofdegenerative myopia with macular CNV.