TY - JOUR
T1 - The Association of Fluid Volatility With Subretinal Hyperreflective Material and Ellipsoid Zone Integrity in Neovascular AMD
AU - Ehlers, Justis P.
AU - Patel, Nikhil
AU - Kaiser, Peter K.
AU - Heier, Jeffrey S.
AU - Brown, David M.
AU - Meng, Xiangyi
AU - Reese, Jamie
AU - Lunasco, Leina
AU - Le, Thuy K.
AU - Hu, Ming
AU - Srivastava, Sunil K.
N1 - Funding Information:
Supported by a research grant provided by Novartis Pharmaceuticals (East Hanover, NJ, USA) and by a grant from the National Eye Institute, National Institutes of Health (NIH/NEI K23-EY022947-01A1). Medical writing support was provided by Ann Todd (IMPRINT Science, New York, NY, USA) and was funded by Novartis Pharmaceuticals. This manuscript was developed in accordance with Good Publication Practice (GPP3) guidelines. Authors had full control of the content and made the final decision on all aspects of this publication.
Publisher Copyright:
Copyright 2022 The Authors.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - PURPOSE: To evaluate the association of fluid volatility with ellipsoid zone (EZ) integrity and subretinal hyperreflective material (SHRM) volume during anti-vascular endothelial growth factor (VEGF) therapy in neovascular age-related macular degeneration (nAMD).METHODS: This study was a post hoc analysis of the OSPREY study. Retinal volatility was quantified as the standard deviation across weeks 12 to 56 for six optical coherence tomography (OCT) metrics: central subfield thickness (CST), total fluid (TF) volume, subretinal fluid (SRF) volume, intraretinal fluid (IRF) volume, macular total retinal fluid index (TRFI), and central macular TRFI. Eyes with volatility ≤ 25th or ≥ 75th percentile values were compared.RESULTS: Eyes with low volatility in several exudative metrics showed greater change from baseline in SHRM volume at week 12 than eyes with high volatility. During the maintenance phase (weeks 12-56), eyes exhibiting high SRF volatility demonstrated increased SHRM volume compared to eyes with low SRF volatility (P = 0.027). Eyes exhibiting high volatility in CST, TF, and SRF demonstrated less improvement in EZ total attenuation (P < 0.001, P = 0.033, and P = 0.043, respectively) than eyes with low volatility. Early exudative instability (i.e., between weeks 4-8 or weeks 8-12) in multiple parameters (i.e., CST, TF, IRF, macular TRFI, or central macular TRFI) was associated with greater volatility during the maintenance phase (P < 0.05).CONCLUSIONS: Greater volatility in exudative OCT metrics, particularly SRF volatility, was associated with a greater increase in SHRM and less improvement in EZ integrity, suggesting that volatility is detrimental to multiple anatomic features in nAMD. Early exudative instability during the loading phase of treatment was associated with longer-term volatility in exudation.
AB - PURPOSE: To evaluate the association of fluid volatility with ellipsoid zone (EZ) integrity and subretinal hyperreflective material (SHRM) volume during anti-vascular endothelial growth factor (VEGF) therapy in neovascular age-related macular degeneration (nAMD).METHODS: This study was a post hoc analysis of the OSPREY study. Retinal volatility was quantified as the standard deviation across weeks 12 to 56 for six optical coherence tomography (OCT) metrics: central subfield thickness (CST), total fluid (TF) volume, subretinal fluid (SRF) volume, intraretinal fluid (IRF) volume, macular total retinal fluid index (TRFI), and central macular TRFI. Eyes with volatility ≤ 25th or ≥ 75th percentile values were compared.RESULTS: Eyes with low volatility in several exudative metrics showed greater change from baseline in SHRM volume at week 12 than eyes with high volatility. During the maintenance phase (weeks 12-56), eyes exhibiting high SRF volatility demonstrated increased SHRM volume compared to eyes with low SRF volatility (P = 0.027). Eyes exhibiting high volatility in CST, TF, and SRF demonstrated less improvement in EZ total attenuation (P < 0.001, P = 0.033, and P = 0.043, respectively) than eyes with low volatility. Early exudative instability (i.e., between weeks 4-8 or weeks 8-12) in multiple parameters (i.e., CST, TF, IRF, macular TRFI, or central macular TRFI) was associated with greater volatility during the maintenance phase (P < 0.05).CONCLUSIONS: Greater volatility in exudative OCT metrics, particularly SRF volatility, was associated with a greater increase in SHRM and less improvement in EZ integrity, suggesting that volatility is detrimental to multiple anatomic features in nAMD. Early exudative instability during the loading phase of treatment was associated with longer-term volatility in exudation.
KW - fluctuation
KW - intraretinal fluid
KW - neovascular age-related macular degeneration
KW - optical coherence tomography
KW - subretinal fluid
KW - Vascular Endothelial Growth Factor A
KW - Fluorescein Angiography/methods
KW - Intravitreal Injections
KW - Humans
KW - Retina
KW - Wet Macular Degeneration/diagnosis
KW - Visual Acuity
KW - Angiogenesis Inhibitors/therapeutic use
KW - Subretinal Fluid
KW - Ranibizumab/therapeutic use
KW - Tomography, Optical Coherence/methods
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U2 - 10.1167/iovs.63.6.17
DO - 10.1167/iovs.63.6.17
M3 - Article
C2 - 35713892
AN - SCOPUS:85132454771
SN - 0146-0404
VL - 63
SP - 17
JO - Investigative Ophthalmology and Visual Science
JF - Investigative Ophthalmology and Visual Science
IS - 6
M1 - 17
ER -