Predictive Findings of Visual Outcome in Spectral Domain Optical Coherence Tomography after Ranibizumab Treatment in Age-related Macular Degeneration

• Published in: Korean journal of ophthalmology Vol. 28; no. 5; pp. 386 - 392
• Main Authors: Kwon, Yoon Hyung, Lee, Dong Kyu, Kim, Hyung Eun, Kwon, Oh Woong
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Ophthalmological Society 01.10.2014; 대한안과학회
• Subjects: Aged; Aged, 80 and over; Angiogenesis Inhibitors - therapeutic use; Choroidal Neovascularization - drug therapy; Choroidal Neovascularization - physiopathology; Female; Humans; Intravitreal Injections; Male; Middle Aged; Original; Ranibizumab - therapeutic use; Retinal Photoreceptor Cell Inner Segment - pathology; Retinal Photoreceptor Cell Outer Segment - pathology; Tomography, Optical Coherence; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity - physiology; Wet Macular Degeneration - drug therapy; Wet Macular Degeneration - physiopathology; 안과학; Macular degeneration; Choroidal neovascularization; Optical coherence tomography
• ISSN: 1011-8942; 2092-9382; 2092-9382
• DOI: 10.3341/kjo.2014.28.5.386

To investigate which spectral domain optical coherence tomography (SD-OCT) findings predict visual outcome after anti-vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (NV-AMD). We reviewed the medical records of patients with treatment-naïve NV-AMD who underwent three or more consecutive anti-VEGF injections. The patients were divided into three groups according to their changes of visual acuity (VA); improved (group I), static (group S), or worsened (group W). We assessed the incidences and values of all available SD-OCT findings of these groups, compared these findings between the three groups and compared the initial values with the post-treatment values. Better initial VA and longer external limiting membrane (ELM) length were associated with less change in VA after anti-VEGF treatment. The initial VA was mildly correlated with initial photoreceptor inner and outer segment junction (IS/OS) length and initial ELM length. The final VA was also mildly correlated with the final IS/OS length and the final ELM length. VA was significantly changed after anti-VEGF treatment in groups W and I. With regard to incidence, disruption of the IS/OS (IS/OS-D), disruption of the ELM (ELM-D) and ELM length differed significantly between the three groups, particularly ELM-D. The incidences of IS/OS-D and ELM-D in group I were significantly lower than those in groups S and W, and those in group S were also lower than those in group W. The ELM length in group I was significantly longer than it was in groups S and W, and the ELM length in group S was longer than that for group W. However, these three findings did not change after the anti-VEGF treatment. Initial IS/OS-D, ELM length and particularly ELM-D can be useful predictors of the visual outcome after anti-VEGF treatment in NV-AMD patients.