Two different initial treatment regimens of ranibizumab in myopic choroidal neovascularization: 12‐month results from a randomized controlled study

摘要

Importance The optimal treatment regimen for myopic choroidal neovascularization (mCNV) is essential to understand but currently poorly studied. Background To date, there is still no consensus on the optimal dosage and frequency of anti‐vascular endothelial growth factor injections in treating mCNV. Design A prospective, single‐centre, single‐blind, randomized controlled study. Participants Adult patients with active mCNV. Methods Patients were randomized 1:1 to one or three doses initial ranibizumab treatments. Additional injections were administered pro re nata (prn) over 12?mo. Main Outcome Measures Number and frequency of injections. Results Fifty patients participated in the study. Patients in both 1?+?prn or 3?+?prn groups experienced similar best‐corrected visual acuity gain and anatomical improvement, including central retinal thickness (CRT), CNV thickness, area of CNV and area of leakage. Over 12?mo, patients in the 1?+?prn group received fewer ranibizumab injections (2.04?±?1.22) compared with the 3?+?prn group (3.58?±?0.72, P 0.0001), but no statistic difference of the injection received was observed in the prn period. During the follow‐up, 15 of 26 eyes in the 1?+?prn group and 10 of 24 eyes in the 3?+?prn group received additional injections after initial dosing ( P ?=?0.2575). Cox regression analysis showed that 1?+?prn, female, age??55?y and CRT??300?μm are risk factors for retreatment. Conclusions and Relevance The eyes with a single loading dose achieved parallel anatomical and functional visual improvement, while required less injections over 1?y. The risk factors for retreatment include 1?+?prn, female, older age and thick retina thickness.