AIM: To investigate the efficacy of photodynamic therapy(PDT)and intravitreal injection with ranibizumab on macular choroidal neovascularization(CNV)of pathologic myopia(PM).

METHODS: There were patients(32 eyes)who were diagnosed as PM with CNV. Randomly selected 16 cases(16 eyes)which were given the PDT treatment(PDT group). The remaining were given both PDT and intravitreal injection with ranibizumab(combination group). There is no significant difference on macular edema between two groups. We analyzed the changes in the best corrected visual activity(BCVA), optic coherence tomograph(OCT)and fundus fluorescein angiography(FFA)before and 1, 6mo after treatment.

RESULTS: One month after the treatment in PDT group: the BCVA increased while the CMT decreased compared with that of pretreatment(P<0.05). One month after the treatment in combination group: the BCVA increased while the CMT decreased significantly compared with that of pretreatment(P<0.01); the changes of BCVA and CMT showed statistically significant between the two groups(P<0.05). Six month after the treatment in PDT group: the BCVA increased while the CMT decreased compared with that of pretreatment(P<0.05). Six month after the treatment in combination group: the BCVA increased while the CMT decreased significantly compared with that of pretreatment(P<0.01); compared with changes of BCVA and CMT in two groups, the difference was significant after treatment(P<0.05). Compared 1mo with 6mo after treatment: there was no significant difference in the BCVA and CMT changes(P<0.05). One month after treatment: in PDT group, FFA showed no leakage or reduced leakage of CNV in 11 eyes(69%), and the fundus remained leaky in 5 eyes(31%); in combination group, FFA showed no leakage or reduced leakage of CNV in 13 eyes(81%); the fundus remained leaky in 3 eyes(19%). Six month after treatment: in PDT group, FFA showed no leakage or reduced leakage in 10 eyes(62.5%); the fundus remained leaky in 4 eyes(25%); two eyes(12.5%)relapsed leakage; in combination group, FFA showed no leakage or reduced leakage of CNV in 15 eyes(94%); the fundus remained leaky in 1 eye(6%).

CONCLUSION: Not only PDT but also PDT and intravitreal injection with ranibizumab can block CNV of pathologic myopia completely or partly, and reduce the danger causing descent of vision. Effects and the stability of the combination therapy is superior to PDT treatment.