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Florian Sulzbacher, Christopher Kiss, Stefan Eisenkoelbl, Marion Munk, Georgios Mylonas, Philipp Roberts, Ursula Schmidt-Erfurth; Functional Treatment Response In Neovascular Age-related Macular Degeneration: Correlating Retinal Sensitivity Change And Sd-oct Morphology After 12 Month Of Monthly Ranibizumab. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4399.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the functional treatment response after 12 month of monthly ranibizumab in patients with neovascular age-related macular degeneration (nAMD) in relation to the initial SD-OCT finding
Twenty two eyes showing untreated nAMD were examined with the Heidelberg Spectralis-OCT (SD-OCT) and the NIDEK MP-1 microperimetry (MP) at baseline and after 12 monthly injections of ranibizumab. The fundusphoto (FP) of the MP was exactly matched with the infrared+OCT image of the SD-OCT using imaging processing software. Each test point of light sensitivity in the FP was transmitted to the corresponding location on SD-OCT and subsequently the microperimetric results were evaluated with respect to the following OCT-findings: neovascular complex (NVC), pigment epithelium detachment (PED), subretinal fluid (SRF), intraretinal fluid (IRF) and intraretinal cysts (IRC) at baseline and after 12 monthly injections
After 1 year of monthly ranibizumab injections locations of NVC recovered in 62% with a median function gain of 4dB [0dB; 11dB], 38% developed a fibrosis with a median functional response of 0dB [0dB; 4dB]. SRF recovered in 99% and was associated with a median functional gain of 7dB [3dB; 13dB], whereas IRF recovered in 99% with a median gain of 5,5dB [0dB; 11dB]. Cysts disappeared in 95% with a median functional gain of 4dB [0dB; 10dB]. A serous PED flattened to normal retinal configuration in 72% and showed a median functional increase of 10dB [1dB; 16dB], in 28% of a decreasing serous PED a median function gain of values of 4dB [0B; 10dB] was assessed. A fibrovascular PED flattened to normal retinal configuration in 55% and showed a median functional gain of 0dB [-1,5B; 7dB], in 45% a fibrovascular PED decreased and showed a median function gain of 0dB [0B; 2,5dB].
Based on the initial OCT finding the possible treatment response can be predicted. The most distinctive functional benefit after 12 monthly ranibizumab injections was observed at sites of initial SRF, followed by serous PED and IRF. An intial NVC showed a marked functional benefit in more than every other case whereas treatment of a fibrovascular PED showed no functional response.
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