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Kyung Hoon Seo, Seung Won Lee, Moo Sang Kim, Seung-Young Yu, Hyung-Woo Kwak; Progression of Atrophy Following Intravitreal anti-VEGF for Exudative AMD. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3598.
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To evaluate and quantify retinal pigment epithelium (RPE) atrophic changes occurring in patient with exudative age-related macular degeneration (AMD) after treatment with anti-vascular endothelial growth factor (VEGF)
This study is a retrospective study. Forty-six eyes of 46 consecutive patients with exudative AMD who had received treatment with anti-VEGF therapy and followed for more 24 months were collected and analyzed from medical record. Patients who had fundus autofluorescence (AF) images at baseline and at followed for more 24 months were included. Semi-automated atrophy detection and quantification was independently performed using customized software (RegionFinder, Heidelberg Engineering, Heidelberg, Germany). A stepwise multivariate linear regression analysis was used to investigate factors that may be associated with the enlargement of RPE atrophy at follow-up.
The mean duration of follow up was 32.9 months and the mean number of anti-VEGF injections received was 6.59. At baseline, the mean size of atrophic area was 2.043 square millimeter (95% confidence interval 1.38 - 2.68 square millimeter). The mean size of atrophic area was significantly increased by final follow-up of 24 months (3.212 square millimeter, p<0.001). The mean progression rate of atrophic area was an enlargement of 0.723 square millimeter per year between baseline and 12 months and 0.470 square millimeter per year between 12 months and 24 months (p=0.401, respectively). The significant predictors in multivariate linear regression modeling for the dependent variable 24 months atrophic area was the baseline atrophic area (p<0.001). The number of anti-VEGF injections appeared no correlation with the size of atrophic area (p=0.075).
RPE atrophic changes occurring in exudative AMD undergoing anti-VEGF therapy developed enlargement of size during the follow-up. The larger the baseline areas, the greater areas of RPE atrophy at final follow-up.
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