Visual Acuity Outcomes of Ranibizumab Treatment in Pathologic Myopic Eyes with Macular Retinoschisis and Choroidal Neovascularization

PURPOSE To investigate visual and morphological outcome in eyes with MRS and choroidal neovascularization (CNV) secondary to pathologic myopia treated with intravitreal (IVT) ranibizumab. METHODS Post hoc analysis of the patients included in the RADIANCE trial (n = 277) was performed to evaluate the impact of MRS on the functional outcome in patients with myopic choroidal neovascularization (mCNV) undergoing intravitreal ranibizumab injections. RESULTS Prevalence of MRS in pathologic myopia population is 6%. Respective patients were generally older than patients without MRS. Study eyes with MRS at baseline (BL) showed an initially poor treatment response after 3 months (mean change in best corrected visual acuity (BCVA) was 2.8 ± 12.4 letters, P = 0.009). After 12 months of treatment however, the mean change in BCVA was 7.1 ± 14.5 early treatment diabetic retinopathy study (ETDRS) letters (P = 0.025). Patients with MRS at baseline received more intravitreal injections than the other RADIANCE patients without MRS (MRS, n = 15 eyes: 5.8 ± 2.1 vs. RADIANCE non-MRS [n = 207 eyes]: 4.0 ± 2.9; P = 0.0001). CONCLUSION Improvement of visual acuity is delayed and reduced after 3 months intravitreal ranibizumab in eyes with MRS and myopic choroidal neovascularization compared to eyes without MRS. More ranibizumab injections are needed in eyes with MRS to gain comparable BCVA at Month 12.