Evaluation of Antiangiogenic Treatment Results in Choroidal Neovascularization Related to Pathological Myopia

Detalhes bibliográficos
Autor(a) principal: Carvalho, Beatriz
Data de Publicação: 2014
Outros Autores: Freitas-Costa, Paulo, Pinheiro-Costa, João, Falcão, Manuel, Carneiro, Ângela, Falcão-Reis, Fernando
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2038
Resumo: Introduction: Choroidal neovascularization secondary to pathological myopia is one of the leading causes of irreversible central vision loss in younger patients. The purposes of our study is to evaluate the long-term results of antiangiogenic treatment, with ranibizumab and/or bevacizumab, in myopic choroidal neovascularization and define the predictive factors for visual and anatomic outcomes.Material and Methods: In this study were included 84 eyes from 81 patients with myopic choroidal neovascularization. Eighty-four (100%) eyes accomplish 12 months of follow-up, 67 (79.8%) 24 months, 54 (64.3%) 36 months, 29 (34.5%) 48 months, and 15 (16.7%) 60 months. We retrieved data related to best corrected visual acuity measured with ETDRS chart, foveal center thickness on optical coherence tomography and fluorescein angiographic findings, before and after treatment.Results: The best corrected visual acuity and foveal center thickness improvements were statistically significant for all follow-up times (p < 0.05). Mean baseline best corrected visual acuity was 43.7 ± 20.1 letters and mean baseline foveal center thickness was 304.8 ± 127.9μm. Mean best corrected visual acuity was 55.6 ± 18.5, 52.1 ± 22.3, 52.1 ± 22.6, 50.3 ± 23.8 and 47.8 ± 24.5 for 12, 24, 36, 48 and 60 months of treatment, respectively. Mean foveal center thickness was 209.7 ± 86.2, 190.6 ± 76.1, 174.7 ± 60.6, 189.8 ± 96.7 and 159.4 ± 73.3 for the same follow-up times. Baseline best corrected visual acuity was the only predictive factor for better visual outcome (p < 0.001).Discussion/Conclusion: Intravitreal anti-VEGF injections in patients with myopic choroidal neovascularization yielded a significant and sustained functional and anatomic improvement. Randomized long-term clinical trials are needed to determine the sustained efficacy of these drugs.
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spelling Evaluation of Antiangiogenic Treatment Results in Choroidal Neovascularization Related to Pathological MyopiaAvaliação dos Resultados do Tratamento Antiangiogénico na Neovascularização Coroideia Associada à Miopia PatológicaIntroduction: Choroidal neovascularization secondary to pathological myopia is one of the leading causes of irreversible central vision loss in younger patients. The purposes of our study is to evaluate the long-term results of antiangiogenic treatment, with ranibizumab and/or bevacizumab, in myopic choroidal neovascularization and define the predictive factors for visual and anatomic outcomes.Material and Methods: In this study were included 84 eyes from 81 patients with myopic choroidal neovascularization. Eighty-four (100%) eyes accomplish 12 months of follow-up, 67 (79.8%) 24 months, 54 (64.3%) 36 months, 29 (34.5%) 48 months, and 15 (16.7%) 60 months. We retrieved data related to best corrected visual acuity measured with ETDRS chart, foveal center thickness on optical coherence tomography and fluorescein angiographic findings, before and after treatment.Results: The best corrected visual acuity and foveal center thickness improvements were statistically significant for all follow-up times (p < 0.05). Mean baseline best corrected visual acuity was 43.7 ± 20.1 letters and mean baseline foveal center thickness was 304.8 ± 127.9μm. Mean best corrected visual acuity was 55.6 ± 18.5, 52.1 ± 22.3, 52.1 ± 22.6, 50.3 ± 23.8 and 47.8 ± 24.5 for 12, 24, 36, 48 and 60 months of treatment, respectively. Mean foveal center thickness was 209.7 ± 86.2, 190.6 ± 76.1, 174.7 ± 60.6, 189.8 ± 96.7 and 159.4 ± 73.3 for the same follow-up times. Baseline best corrected visual acuity was the only predictive factor for better visual outcome (p < 0.001).Discussion/Conclusion: Intravitreal anti-VEGF injections in patients with myopic choroidal neovascularization yielded a significant and sustained functional and anatomic improvement. Randomized long-term clinical trials are needed to determine the sustained efficacy of these drugs.Introdução: A neovascularização coroideia associada à miopia patológica é uma das principais causas de perda de visão central e irreversível em indivíduos jovens. Os objetivos deste estudo são avaliar os resultados a longo prazo do tratamento antiangiogénico, com ranibizumab e/ou bevacizumab, na neovascularização coroideia associada à miopia patológica e caraterizar os fatores preditivos dos resultados funcionais e anatómicos obtidos.Material e Métodos: Avaliámos os resultados de 84 olhos de 81 doentes com neovascularização coroideia miópica, dos quais 84 (100%) completaram 12 meses de seguimento, 67 (79,8%) 24 meses de seguimento, 54 (64,3%) 36 meses de seguimento, 29 (34,5%) 48 meses de seguimento e 15 (16,7%) 60 meses de seguimento. Procedemos à recolha de dados relativos à melhor acuidade visual corrigida em escala ETDRS, espessura foveal na tomografia de coerência óptica e caraterísticas da angiografia fluoresceínica, inicial e após tratamento.Resultados: As melhorias na melhor acuidade visual corrigida e na espessura foveal foram significativas para todos os tempos de seguimento (p < 0,05). A média da melhor acuidade visual corrigida inicial era de 43,7 ± 20,1 letras e da espessura foveal inicial de 304,8 ± 127,9μm. As médias da melhor acuidade visual corrigida foram de 55,6 ± 18,5, 52,1 ± 22,3, 52,1 ± 22,6, 50,3 ± 23,8 e 47,8 ± 24,5 para os 12, 24, 36, 48 e 60 meses de tratamento, respetivamente. As médias das espessuras foveais foram de 209,7 ± 86,2, 190,6 ± 76,1, 174,7 ± 60,6, 189,8 ± 96,7 e 159,4 ± 73,3 para os mesmos tempos de seguimento. Apenas a melhor acuidade visual corrigida inicial foi preditiva de melhores resultados na melhor acuidade visual corrigida final (p < 0,001).Discussão/Conclusão: As injecções intravítreas de anti-VEGF em doentes com neovascularização coroideia miópica cursam com uma melhoria funcional e anatómica significativa e sustentada no tempo. Ensaios clínicos randomizados com follow-up mais extenso são necessários para comprovar a eficácia sustentada destes agentes.Ordem dos Médicos2014-01-08info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2038oai:ojs.www.actamedicaportuguesa.com:article/2038Acta Médica Portuguesa; Vol. 27 No. 1 (2014): January-February; 49-58Acta Médica Portuguesa; Vol. 27 N.º 1 (2014): Janeiro-Fevereiro; 49-581646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2038https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2038/3872https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2038/3959Carvalho, BeatrizFreitas-Costa, PauloPinheiro-Costa, JoãoFalcão, ManuelCarneiro, ÂngelaFalcão-Reis, Fernandoinfo:eu-repo/semantics/openAccess2022-12-20T10:59:42Zoai:ojs.www.actamedicaportuguesa.com:article/2038Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:17:31.557760Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Evaluation of Antiangiogenic Treatment Results in Choroidal Neovascularization Related to Pathological Myopia
Avaliação dos Resultados do Tratamento Antiangiogénico na Neovascularização Coroideia Associada à Miopia Patológica
title Evaluation of Antiangiogenic Treatment Results in Choroidal Neovascularization Related to Pathological Myopia
spellingShingle Evaluation of Antiangiogenic Treatment Results in Choroidal Neovascularization Related to Pathological Myopia
Carvalho, Beatriz
title_short Evaluation of Antiangiogenic Treatment Results in Choroidal Neovascularization Related to Pathological Myopia
title_full Evaluation of Antiangiogenic Treatment Results in Choroidal Neovascularization Related to Pathological Myopia
title_fullStr Evaluation of Antiangiogenic Treatment Results in Choroidal Neovascularization Related to Pathological Myopia
title_full_unstemmed Evaluation of Antiangiogenic Treatment Results in Choroidal Neovascularization Related to Pathological Myopia
title_sort Evaluation of Antiangiogenic Treatment Results in Choroidal Neovascularization Related to Pathological Myopia
author Carvalho, Beatriz
author_facet Carvalho, Beatriz
Freitas-Costa, Paulo
Pinheiro-Costa, João
Falcão, Manuel
Carneiro, Ângela
Falcão-Reis, Fernando
author_role author
author2 Freitas-Costa, Paulo
Pinheiro-Costa, João
Falcão, Manuel
Carneiro, Ângela
Falcão-Reis, Fernando
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Carvalho, Beatriz
Freitas-Costa, Paulo
Pinheiro-Costa, João
Falcão, Manuel
Carneiro, Ângela
Falcão-Reis, Fernando
description Introduction: Choroidal neovascularization secondary to pathological myopia is one of the leading causes of irreversible central vision loss in younger patients. The purposes of our study is to evaluate the long-term results of antiangiogenic treatment, with ranibizumab and/or bevacizumab, in myopic choroidal neovascularization and define the predictive factors for visual and anatomic outcomes.Material and Methods: In this study were included 84 eyes from 81 patients with myopic choroidal neovascularization. Eighty-four (100%) eyes accomplish 12 months of follow-up, 67 (79.8%) 24 months, 54 (64.3%) 36 months, 29 (34.5%) 48 months, and 15 (16.7%) 60 months. We retrieved data related to best corrected visual acuity measured with ETDRS chart, foveal center thickness on optical coherence tomography and fluorescein angiographic findings, before and after treatment.Results: The best corrected visual acuity and foveal center thickness improvements were statistically significant for all follow-up times (p < 0.05). Mean baseline best corrected visual acuity was 43.7 ± 20.1 letters and mean baseline foveal center thickness was 304.8 ± 127.9μm. Mean best corrected visual acuity was 55.6 ± 18.5, 52.1 ± 22.3, 52.1 ± 22.6, 50.3 ± 23.8 and 47.8 ± 24.5 for 12, 24, 36, 48 and 60 months of treatment, respectively. Mean foveal center thickness was 209.7 ± 86.2, 190.6 ± 76.1, 174.7 ± 60.6, 189.8 ± 96.7 and 159.4 ± 73.3 for the same follow-up times. Baseline best corrected visual acuity was the only predictive factor for better visual outcome (p < 0.001).Discussion/Conclusion: Intravitreal anti-VEGF injections in patients with myopic choroidal neovascularization yielded a significant and sustained functional and anatomic improvement. Randomized long-term clinical trials are needed to determine the sustained efficacy of these drugs.
publishDate 2014
dc.date.none.fl_str_mv 2014-01-08
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 27 No. 1 (2014): January-February; 49-58
Acta Médica Portuguesa; Vol. 27 N.º 1 (2014): Janeiro-Fevereiro; 49-58
1646-0758
0870-399X
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