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Recovery of photoreceptor outer segments after anti-VEGF therapy for age-related macular degeneration

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To evaluate whether the status of the external limiting membrane (ELM) or inner segment/outer segment junction (IS/OS) improves after intravitreal injection of ranibizumab for age-related macular degeneration (AMD). We also evaluated whether the pre-operative values of these parameters are associated with the visual prognosis.

Methods

This was a hospital-based, cross-sectional study. Seventy-six eyes of 76 treatment-naive AMD patients who received three monthly intravitreal injections of ranibizumab followed for more than 6 months with additional as-needed injections were investigated. Spectral domain OCT was used to evaluate the length of ELM, IS/OS, and foveal thickness pre- and post-operatively. Changes of ELM and IS/OS length were evaluated postoperatively. Correlation coefficients between pre-operative parameters and post-operative visual acuity were also analyzed.

Results

Significant changes were noted in mean logMAR (0.66 to 0.53), foveal thickness (231.1 to 151.1 μm), and IS/OS length (514.9 to 832.3 μm) after the treatment. ELM length did not improve significantly (1,312.4 to 1,376.7 μm). Restoration of IS/OS occured where ELM is retained. Although pre-operative ELM length, IS/OS length, and foveal thickness showed correlation with post-operative logMAR (R = –0.51, –0.39, and 0.46, respectively), the most powerful predictive factor for visual prognosis was pre-operative logMAR (R = 0.77, p < 0.001).

Conclusions

IS/OS status improves in response to anti-VEGF therapy but ELM seems to have less plasticity. The status of IS/OS and ELM can be used as prognostic factors but the predictive power is inferior to that of baseline visual acuity.

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Acknowledgments

The study was supported in part by a Grant-In-Aid for Scientific Research (No. 22791706) from the Japanese Society for the Promotion of Science, Tokyo. Financial disclosures: none.

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Authors and Affiliations

  1. Department of Ophthalmology, Kobe City Medical Center General Hospital, 4-6 Minatojima-minamimachi, Chuo-ku, Kobe, 650-0046, Japan

    Akio Oishi, Masataka Shimozono, Michiko Mandai, Masayuki Hata, Akihiro Nishida & Yasuo Kurimoto

  2. Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Akio Oishi

  3. Laboratory for Retinal Regeneration, Center for Developmental Biology, RIKEN, Kobe, Japan

    Michiko Mandai

Authors
  1. Akio Oishi
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  2. Masataka Shimozono
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  3. Michiko Mandai
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  4. Masayuki Hata
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  5. Akihiro Nishida
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  6. Yasuo Kurimoto
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Correspondence to Akio Oishi.

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The authors have no proprietary interest in any aspect of this study.

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Oishi, A., Shimozono, M., Mandai, M. et al. Recovery of photoreceptor outer segments after anti-VEGF therapy for age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 251, 435–440 (2013). https://doi.org/10.1007/s00417-012-2034-4

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  • DOI: https://doi.org/10.1007/s00417-012-2034-4

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