TY - JOUR
T1 - Morphological characteristics of eyes with neovascular age-related macular degeneration and good long-term visual outcomes after anti-VEGF therapy
AU - Fang, Mengyuan
AU - Chanwimol, Karntida
AU - Maram, Jyotsna
AU - Datoo O’Keefe, Ghazala A.
AU - Wykoff, Charles C.
AU - Sarraf, David
AU - Brown, Asha
AU - Lampen, Shaun Ian Retief
AU - Zhou, Brenda
AU - Rusakevich, Alexander M.
AU - Sadda, Srini Vas
N1 - Funding Information:
The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Publisher Copyright:
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/3
Y1 - 2023/3
N2 - Purpose To analyse the morphological characteristics of eyes with neovascular age-related macular degeneration (AMD) with good long-term visual acuity after anti-VEGF (vascular endothelial growth factor) therapy. Methods Retrospective, observational study of 175 patients with neovascular AMD with >5 years of followup after initiating anti-VEGF therapy. Spectral-domain optical coherence tomography images were assessed for thickness of pigment epithelial detachment (PED), subretinal hyper-reflective material (SHRM), subretinal fluid and subfoveal choroidal, as well as the integrity of the outer retinal bands. Results The final analysis cohort included 203 eyes (175 patients) followed for a mean of 7.84±1.70 years (range: 5–11). The maximum PED thickness in the foveal central subfield (FCS) was significantly lower (p<0.001) in the poor vision group (13.11 μm) compared with the intermediate (86.25 μm) or good (97.92 μm) vision groups, respectively. In contrast, the maximum thickness of SHRM in the FCS was significantly thicker (p<0.001) in eyes with poor vision (149.46 μm) compared with eyes with intermediate vision (64.37 μm) which in turn were significantly thicker (p<0.001) than eyes with good vision (9.35 μm). The good vision group also had better continuity of all outer retinal bands (external limiting membrane, ellipsoid zone, and retinal pigment epithelium) compared with the other two groups (all p<0.001). Conclusion A thicker PED and thinner SHRM were correlated with better vision in eyes with neovascular AMD following long-term anti-VEGF therapy. If replicated in future prospective studies, these findings may have implications for design of optimal anatomic endpoints for neovascular AMD treatment.
AB - Purpose To analyse the morphological characteristics of eyes with neovascular age-related macular degeneration (AMD) with good long-term visual acuity after anti-VEGF (vascular endothelial growth factor) therapy. Methods Retrospective, observational study of 175 patients with neovascular AMD with >5 years of followup after initiating anti-VEGF therapy. Spectral-domain optical coherence tomography images were assessed for thickness of pigment epithelial detachment (PED), subretinal hyper-reflective material (SHRM), subretinal fluid and subfoveal choroidal, as well as the integrity of the outer retinal bands. Results The final analysis cohort included 203 eyes (175 patients) followed for a mean of 7.84±1.70 years (range: 5–11). The maximum PED thickness in the foveal central subfield (FCS) was significantly lower (p<0.001) in the poor vision group (13.11 μm) compared with the intermediate (86.25 μm) or good (97.92 μm) vision groups, respectively. In contrast, the maximum thickness of SHRM in the FCS was significantly thicker (p<0.001) in eyes with poor vision (149.46 μm) compared with eyes with intermediate vision (64.37 μm) which in turn were significantly thicker (p<0.001) than eyes with good vision (9.35 μm). The good vision group also had better continuity of all outer retinal bands (external limiting membrane, ellipsoid zone, and retinal pigment epithelium) compared with the other two groups (all p<0.001). Conclusion A thicker PED and thinner SHRM were correlated with better vision in eyes with neovascular AMD following long-term anti-VEGF therapy. If replicated in future prospective studies, these findings may have implications for design of optimal anatomic endpoints for neovascular AMD treatment.
KW - imaging
KW - retina
KW - treatment other
KW - Vascular Endothelial Growth Factor A
KW - Intravitreal Injections
KW - Tomography, Optical Coherence
KW - Humans
KW - Wet Macular Degeneration/diagnosis
KW - Visual Acuity
KW - Retinal Detachment/drug therapy
KW - Angiogenesis Inhibitors/therapeutic use
KW - Ranibizumab/therapeutic use
KW - Retrospective Studies
KW - Fluorescein Angiography
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U2 - 10.1136/bjophthalmol-2021-319602
DO - 10.1136/bjophthalmol-2021-319602
M3 - Article
C2 - 34561217
AN - SCOPUS:85130615941
SN - 0007-1161
VL - 107
SP - 399
EP - 405
JO - British Journal of Ophthalmology
JF - British Journal of Ophthalmology
IS - 3
ER -