| Summary: | Pathologic myopia (PM) is caused by the progressive and excessive elongation of the axial length of the eyeball. Myopic choroidal neovascularization (CNV) is a complication of PM and is a serious threat to vision. CNV is observed as an abnormal growth of blood vessels located between the neurosensory retina and the retinal pigment epithelium. Symptoms include a decrease in vision, central scotoma, and/or metamorphopsia. PM has a prevalence of 0.084% among adult Canadians, and myopic CNV is a leading cause of visual disability among young adults.> Verteporfin (Visudyne) photodynamic therapy (vPDT) is the standard of care for myopic CNV in Canada. vPDT retards vision loss in patients with subfoveal CNV and stabilizes, rather than improves, visual acuity (VA). The anti-vascular endothelial growth factor (VEGF) therapies, ranibizumab (Lucentis) and bevacizumab (Avastin), have been used off-label as monotherapies for myopic CNV in Canada. Ranibizumab is approved in Canada for the treatment of neovascular (wet) age-related macular degeneration, the treatment of visual impairment due to macular edema secondary to retinal vein occlusion, and the treatment of visual impairment due to diabetic macular edema. Ranibizumab was recently approved by Health Canada for treating visual impairment due to CNV secondary to PM. Ranibizumab is supplied as a 10 mg/mL solution in single-use vials for intravitreal injection. The recommended dose is a single initial 0.5 mg injection followed by monthly injections, administered as needed based on signs of disease activity. The objective of this review was to perform a systematic review of the beneficial and harmful effects of ranibizumab intravitreal injection for the treatment of visual impairment due to CNV secondary to PM in adults
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