June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Early changes in retinal morphology during the first three weeks after anti-VEGF (re-)treatment for neovascular age-related macular degeneration
Author Affiliations & Notes
  • Philip Enders
    Center of Ophthalmology, Universitiy Hospital of Cologne, Germany, Cologne, Germany
  • Vasilena Sitnilska
    Center of Ophthalmology, Universitiy Hospital of Cologne, Germany, Cologne, Germany
  • Lebriz Altay
    Center of Ophthalmology, Universitiy Hospital of Cologne, Germany, Cologne, Germany
  • Sascha Fauser
    Center of Ophthalmology, Universitiy Hospital of Cologne, Germany, Cologne, Germany
  • Footnotes
    Commercial Relationships   Philip Enders, None; Vasilena Sitnilska, None; Lebriz Altay, None; Sascha Fauser, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 22. doi:
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      Philip Enders, Vasilena Sitnilska, Lebriz Altay, Sascha Fauser; Early changes in retinal morphology during the first three weeks after anti-VEGF (re-)treatment for neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2017;58(8):22.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To analyze changes of retinal morphology in the first three weeks after anti-VEGF therapy of neovascular age-related macular (nAMD) and to characterize the effect in different retinal compartments.

Methods : In a prospective, non-randomized clinical study (DRKS00010061), 50 patients with new or recurring active CNV secondary to nAMD were monitored weekly by spectral-domain optical coherence tomography (SD-OCT) for three weeks after treatment. 22 patients received bevacizumab, 15 ranibizumab and 13 aflibercept. SD-OCT images were acquired, segmented and graded using a standardized reading center protocol. Morphologic parameters of retinal compartments were assessed and compared over the course of time.

Results : Mean central retinal thickness (CRT) at baseline of 391.22±123.41 µm decreased to 347.17±104.6 µm three weeks after treatment. After one week, CRT was reduced by -26.15 µm (p<0.001), after two by -12.54 µm (p<0.001), and after three weeks by -3.52 µm (p=0.09). Intraretinal layer (IRL) thickness changed only significantly between baseline and week one (p<0.001). In patients with intraretinal fluids and cysts at baseline, IRL change within first week contributed already in average 80% of the total change in this compartment three weeks after treatment. Subretinal fluids and tissues displayed a prolonged significant loss in thickness between baseline and week one (p<0.001) and weeks 1-2 (p=0.01), but not between weeks 2-3 (p=0.07). Dynamics in early retinal morphology following treatment were comparable for all three used agents.

Conclusions : Early morphologic changes in retinal compartments occur primarily in the first 14 days after anti-VEGF treatment. Intraretinal fluids seem to dissolve faster than subretinal fluids and tissue. In patients with response to treatment, early recurrences of CNV activity were not seen in retinal morphology within three weeks after intravitreal application of anti-VEGF.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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