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Retinal pigment epithelial characteristics in eyes with neovascular age-related macular degeneration

Long-term retinal changes under anti-vascular endothelial growth factor treatment

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Summary

Purpose

The aim of this study was to assess retinal pigment epithelial (RPE) and retinal structural changes in eyes with neovascular age-related macular degeneration (AMD) treated with anti-vascular endothelial growth factor (anti-VEGF) during long-term follow-up and to evaluate morphological markers potentially influencing prognosis.

Methods

A total of 18 eyes of 18 patients with neovascular AMD were examined subsequent to completion of the Avastin Versus Lucentis in Age Related Macular Degeneration (MANTA) study following a mean period of 84 months (range 69–93 months). After receiving a loading dose of 3 intravitreal anti-VEGF injections subsequent to baseline of the MANTA study, patients were treated as needed (pro re nata, PRN). Functional and morphological changes were assessed, the latter using spectral domain optical coherence tomography (SD-OCT).

Results

Retinal/RPE atrophy generally increased significantly during follow-up compared to baseline (fibrosis 28% vs. 89%, p = 0.0001, geographic atrophy, GA 0% vs. 67%, p = 0.0002, RPE porosity 61% vs. 100%, p = 0.009) whereas regenerative alterations tendentially increased until 3 months and then subsequently declined until the last visit (RPE thickening 28% vs. 11%, p = 0.22 and intraretinal hyperreflective foci 89% vs. 78%, p = 0.39).

Conclusion

Atrophic alterations of the retina and RPE are progressive and may partly be induced by anti-VEGF. Morphological findings may aid in the identification of prognostic markers in the progression of neovascular AMD. This could lead to a more targeted education of affected patients.

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Funding

The research did not receive any funding. It was performed as part of the employment of the authors. All authors are employed at Hietzing Hospital, department of ophthalmology, and further at the Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery.

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Authors and Affiliations

  1. Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstraße 1, Pavillon 2a and 2b, 1130, Vienna, Austria

    Christian Ebner MD, Clara Wernigg MD, Christopher Schütze MD, PhD, PD, Birgit Weingessel MD, PD &  Pia-Veronika Vécsei-Marlovits MD, MBA

  2. Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Wolkersbergenstraße 1, 1130, Vienna, Austria

    Christian Ebner MD, Clara Wernigg MD, Christopher Schütze MD, PhD, PD, Birgit Weingessel MD, PD &  Pia-Veronika Vécsei-Marlovits MD, MBA

Authors
  1. Christian Ebner MD
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  2. Clara Wernigg MD
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  3. Christopher Schütze MD, PhD, PD
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  4. Birgit Weingessel MD, PD
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  5. Pia-Veronika Vécsei-Marlovits MD, MBA
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Corresponding author

Correspondence to Pia-Veronika Vécsei-Marlovits MD, MBA.

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Conflict of interest

C. Ebner, C. Wernigg, C. Schütze, B. Weingessel, and P.-V. Vécsei-Marlovits declare that they have no financial interests in context with this study. Each of the authors warrants that there are no commercial associations that might pose a conflict of interest in context with the submitted article.

Ethical standards

Signed informed consent was obtained from each patient prior to enrolment. The local ethics committee approved the study protocol that followed the ethical tenets of the Declaration of Helsinki.

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Registration site: ClinicalTrials. Registration number: NCT03679156

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Ebner, C., Wernigg, C., Schütze, C. et al. Retinal pigment epithelial characteristics in eyes with neovascular age-related macular degeneration. Wien Klin Wochenschr 133, 123–130 (2021). https://doi.org/10.1007/s00508-020-01718-6

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  • DOI: https://doi.org/10.1007/s00508-020-01718-6

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