MYRROR 2010.

Methods	Study design: parallel group randomised controlled trial. Unit of randomisation and analysis: the participant (1 study eye per participant). The criteria for eye selection were not reported.
Participants	Country: Asia (Hong Kong, Japan, Republic of Korea, Singapore and Taiwan) Setting: international, multicentre (see appendix of MYRROR 2010) Number of participants: 122 (only 121 participants were included in the full analysis set) Number of men: 29 Number of women: 92 Age (mean ± SD): 58.2 ± 13.3 years Ethnic group: Asian Inclusion criteria: aged ≥ 18 years and had high myopia (defined as ≤ ‐6.0 D or axial length of ≥ 26.5 mm); active (as defined by leakage on FA) subfoveal or juxtafoveal (within 1 to 199 μm from the centre of the fovea) mCNV; BCVA of 73‐35 letters in the study eye. Exclusion criteria: only 1 functional eye; recurrent mCNV or aphakia (including pseudophakia) in the study eye; history or presence of CNV with an origin other than pathological myopia in the study eye; ocular inflammation or external ocular inflammation in the study eye; any iris neovascularisation or vitreous haemorrhage in either eye; uncontrolled glaucoma (defined as intraocular pressure ≥ 25 mmHg on optimal medical regimen); previous filtration surgery in either eye; women of childbearing potential who had a positive pregnancy test result during screening or who intended to breastfeed during the study.
Interventions	Intervention: intravitreal aflibercept 2.0 mg, retreatment afterwards in case CNV persisted or recurred (based on predefined criteria) at monthly follow‐up through week 44. If the assessment for retreatment was negative, participants were given sham injections for masking purpose (90 participants). Comparator: sham injections every month through to week 20. Intravitreal aflibercept 2.0 mg at week 24 and retreatment afterwards in case CNV persisted or recurred at monthly follow‐up from week 28 to week 44 (same treatment regimen as the intervention group) (31 participants).
Outcomes	Primary outcomes: mean change in BCVA from baseline to week 24. Secondary outcomes: proportion of participants who gained ≥ 15 letters at week 24; absolute change or mean change from baseline in CMT (as assessed by OCT at week 24 and week 48); absolute change in CNV lesion size from baseline (as assessed by FA at week 24 and week 48); proportion of participants gaining ≥ 15 letters from baseline at week 48; proportion of participants gaining ≥ 10 letters from baseline at week 24 and week 48; leakage from CNV (as assessed by FA from baseline to week 24 and week 48); change in EuroQol‐5 Dimension score from baseline to week 24 and week 48; change in 25‐item National Eye Institute Visual Function Questionnaire 25 total score from baseline to week 24 and week 48. Follow‐up: 48 weeks VA measurement: ETDRS chart at a distance of 4 m.
Notes	Date conducted: November 2010 to August 2013 Sources of funding: Bayer HealthCare Pharmaceuticals, Leverkusen, Germany Declaration of interest: "The authors take full responsibility for the scope, direction, and content of the manuscript, and have approved the submitted manuscript." Financial interests were not reported. Trial registration: NCT01249664
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not reported
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Quote: "MYRROR was an international, phase III, multicenter, randomised, double‐masked, sham‐controlled study." "patients received sham injections only for masking purposes."
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: "MYRROR was an international, phase III, multicenter, randomised, double‐masked, sham‐controlled study."
Incomplete outcome data (attrition bias) All outcomes	Low risk	Quote: "In total, 122 patients were randomised, of whom 91 received intravitreal aflibercept 2.0 mg and 31 received sham; 122 patients were included in the safety set. In the full analysis set, 121 patients were included (90 patients received intravitreal aflibercept 2.0 mg and 31 received sham)." Comment: according to participant flow data on ClinicalTrials.gov, 5 participants were withdrawn from the study and 1 participant did not complete visits to week 48 due to adverse events, both in the aflibercept group. However, only 1 participant failed to fulfil requirements of full analysis set after randomisation.
Selective reporting (reporting bias)	Low risk	Comment: the outcome measures were prespecified on ClinicalTrials.gov registration. Though some outcomes (e.g. the proportion of participants losing ≥ 5, 10 or 15 letters) were not reported in the manuscript, data were shown in the "study results" section on ClinicalTrials.gov website.
Other bias	Low risk	Comment: no other bias identified.