Retinal Disorders

Graefe's Archive for Clinical and Experimental Ophthalmology

, Volume 251, Issue 6, pp 1483-1488

Enhanced depth imaging of the choroid in patients with neovascular age-related macular degeneration treated with anti-VEGF therapy versus untreated patients

  • Waheeda RahmanAffiliated withMedical Retina Service, Moorfields Eye Hospital Email author 
  • , Fred Kuanfu ChenAffiliated withVitreo-retinal Surgery, Moorfields Eye HospitalNIHR BMRC, Moorfields Eye Hospital
  • , Jonathan YeohAffiliated withVitreo-retinal Surgery, Moorfields Eye Hospital
  • , Lyndon da CruzAffiliated withVitreo-retinal Surgery, Moorfields Eye HospitalNIHR BMRC, Moorfields Eye Hospital

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Abstract

Purpose

To compare the subfoveal choroidal thickness (SFCT) between patients with neovascular age-related macular degeneration (nAMD) who had multiple intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents and those with treatment-naïve nAMD.

Methods

This retrospective case–control study included 15 patients in group 1 (nAMD in one eye which had received at least three anti-VEGF injections and early AMD in the fellow eye) and 15 patients in group 2 (newly diagnosed nAMD in one eye which had not received any treatment and early AMD in the fellow eye). They underwent enhanced depth imaging optical coherence tomography (OCT), and two OCT readers manually measured the SFCT. Inter-ocular difference in SFCT (nAMD eye minus fellow eye) was calculated for each patient.

Results

The nAMD eyes in group 1 had received a median (range) of four (3–8) intravitreal injections of anti-VEGF agents, and the OCT scans were performed at a median (range) of 9 (4–17) months after the first injection. The median inter-ocular difference in SFCT in groups 1 and 2 were not significantly different (13.5 and 3.0 μm in groups 1 and 2 respectively, p = 0.60). There was also no statistically significant difference in SFCT between nAMD and fellow eyes (p = 0.16), although there was a trend for greater median SFCT in the nAMD eyes.

Conclusion

The data from this small cohort suggests that no gross reduction in SFCT appears in nAMD patients after a time interval of at least 4 months between initiating repeated treatment with anti-VEGF therapy and OCT imaging. However, a study with a much larger sample size or longitudinal design is required to detect possible small fluctuations in SFCT in nAMD eyes receiving anti-VEGF therapy.

Keywords

Macular degeneration Enhanced depth imaging Optical coherence tomography Ranibizumab Bevacizumab Vascular endothelial growth factor Anti-VEGF