Comparison of Efficacy of Intravitreal Ranibizumab and Aflibercept in Eyes with Myopic Choroidal Neovascularization: 24-Month Follow-Up

Purpose: To compare the 24-month efficacy of intravitreal ranibizumab and aflibercept in treatment-naive patients with myopic choroidal neovascularization (CNV). Methods: Ninety-six naive patients (97 eyes) with myopic CNV were included in this single-center study. Patients received intravitreal ranibizumab (IVR) or aflibercept (IVA) following a pro re nata regimen (PRN). Results: Fifty patients (50 eyes) received 0.5 mg IVR, 46 patients (47 eyes) received 2.0 mg of IVA. There was no significant between-group difference in mean decimal best-corrected visual acuity (BCVA) (P = 0.6) or mean central retinal thickness (CRT) (P = 0.9) at 24 months. The mean +/- standard deviation (SD) BCVA at baseline in the IVR group was 0.21 +/- 0.14 and 0.20 +/- 0.14 in the IVA group. At month 24, BCVA was 0.43 +/- 0.24 (P < 0.001) in the IVR group and 0.41 +/- 0.2 (P < 0.001) in the IVA group. Baseline mean +/- SD CRT was 318 +/- 84 microns in the IVR group and 303 +/- 65 microns in the IVA group. At month 24, CRT was 226 +/- 31 microns in the IVR group (P < 0.001) and 224 +/- 35 microns in the IVA group (P < 0.001). There were no significant differences in the mean number of injections between the IVR group and the IVA group (2.9 +/- 1.2 vs. 2.8 +/- 1.1), (P = 0.7). Conclusions: Our study demonstrates that ranibizumab and aflibercept in a PRN regimen lead to a significant increase of BCVA and decrease in central foveal thickness in treatment-naive patients with myopic CNV after 24 months.