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Fayssal El-Jabali, georgios papastergiou, Michael Bennett, Karl Waite; Specular Photomicrographic Assessment of the Effect of Anti-VEGF intravitreal injections on corneal thickness and endothelial cell density (CD) and morphology. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6264.
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Patients with active Wet Age-related Macular Degeneration (Wet AMD) often receive multiple intraocular injections of Anti-VEGF medications. The objective of this study was to assess changes in corneal endothelial cell density (CECD) and morphology, as well as on corneal thickness in patients receiving anti-VEGF treatments over a period of six to twelve months of therapy.
Fifty five patients with active Wet AMD, who were actively receiving anti-VEGF intravitreal medications were enrolled in a prospective study to measure the changes in corneal endothelial cell density, morphology and associated corneal thickness measurements. Six and twelve month non-contact spectral photomicrographic assessments (Tomey EM-3000) were obtained. Study parameters including number and type of anti-VEGF medication received, corneal endothelial cell density (CECD), central corneal pachymetry, and morphology changes (coefficient of variation CV, standard deviation of cell area SD, mean cell area MCA). The fellow untreated eyes of each patient served as age matched control eyes.
During the first six months, study eyes received an average of 4 ± 1 treatments, and averaged 8 ± 1 treatments by twelve months. The average baseline CD of treated eyes was 2152 ± 286 /mm2 and decreased to 2089 ± 290 (P >0.05) at the midway datapoint. Similarly, the average baseline CD of control eyes was 2351 ± 270 with a decrease to 2274 ± 272 (p>0.05) at the final data point. Average central corneal pachymetry was 540 ± 25 μm at baseline. There was no statistically significant change in corneal pachymetry, mean CV, SD or MCA at the end of the observation period.
The study suggests that frequent administration of anti-VEGF agents over a period of six and twelve months, does not seem to significantly affect corneal endothelial cells or corneal thickness. A longer follow-up is required to determine long-term effects of anti-VEGF on corneal endothelial density and morphology.
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