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Seena Nambiar, Manju Chandran, Narendran Nair, Sidharth Praveen, Malpreet Lidder, Geeta Menon; Comparison of outcome of anti-vascular endothelial growth factor (anti-VEGF) treatment in exudative Age-related Macular Degeneration (AMD) in the presence and absence of Vitreomacular Adhesion (VMA). Invest. Ophthalmol. Vis. Sci. 2013;54(15):3830.
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To compare the outcome of anti-VEGF treatment in exudative AMD in the presence and absence of VMA.
We retrospectively analysed medical records and Optical Coherence Tomography (OCT) scans of 38 patients (38 eyes) who were receiving intravitreal injections of Ranibizumab for exudative AMD. We included 19 patients in Group A (presence of VMA) and 19 patients in the control Group B (no VMA). Both groups were comparable in respect of age distribution, Best Corrected Visual Acuity (BCVA) and central macular thickness (CMT) at baseline. BCVA and CMT were compared between the two groups at baseline and at 12 months
Mean BCVA (ETDRS letters) in Group A at baseline was 57.79 and showed a statistically significant improvement at 12 months by 8.74 letters (P= 0.043). In Group B there was a significant improvement in BCVA from baseline 59.47 over 12 months by 8.16 letters (P=0.040). Baseline CMT in Group A was 315.11microns and showed a significant reduction by 62.27 microns (P=0.016), and Group B showed a reduction in CMT from baseline of 310.48microns by 54.89 microns (P=0.022) at 12 months review.
Our results with a small number of patients showed both groups responded equally well to the anti-VEGF treatment. Presence of vitreomacular adhesion in wet macular degeneration did not seem to affect the response to anti-VEGF treatment, and prompt treatment on diagnosis helps to achieve better visual outcome. Further prospective studies with larger groups of patients over a longer period are needed to fully evaluate if presence of VMA is an indicator for poor response to anti-VEGF treatment in wet AMD.
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