June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Ranibizumab and Bevacizumab Decrease Macular Ganglion Cell Complex (GCC) Thickness Measured with Fourier-Domain Optical Coherence Tomography in Age-Related Macular Degeneration (AMD)
Author Affiliations & Notes
  • Nalin Mehta
    Colorado Retina Center, Lakewood, CO
  • Hugo Quiroz-Mercado
    Department of Ophthalmology, Denver Health Medical Center, Denver, CO
    Department of Ophthalmology, University of Colorado, Denver, CO
  • Michael Sinai
    formerly Optovue Inc., Fremont, CA
  • Kelly Soules
    Optovue Inc., Fremont, CA
  • Anjali Mehta
    Colorado Academy, Denver, CO
  • Shulamit Schwartz
    Department of Ophthalmology, Denver Health Medical Center, Denver, CO
    Department of Ophthalmology, University of Colorado, Denver, CO
  • Footnotes
    Commercial Relationships Nalin Mehta, Optovue Inc. (C); Hugo Quiroz-Mercado, Allegro (C); Michael Sinai, Optovue, Inc. (E); Kelly Soules, Optovue (E); Anjali Mehta, None; Shulamit Schwartz, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4603. doi:
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      Nalin Mehta, Hugo Quiroz-Mercado, Michael Sinai, Kelly Soules, Anjali Mehta, Shulamit Schwartz; Ranibizumab and Bevacizumab Decrease Macular Ganglion Cell Complex (GCC) Thickness Measured with Fourier-Domain Optical Coherence Tomography in Age-Related Macular Degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 2013;54(15):4603.

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

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Abstract
 
Purpose
 

To evaluate the effect of multiple intravitreal injections with ranibizumab and bevacizumab over time on macular GCC thickness in eyes with wet AMD compared to age-matched control eyes with dry AMD.

 
Methods
 

This was a retrospective, observational, case control study of consecutive patients diagnosed with AMD. 24 eyes treated with either ranibizumab or bevacizumab for newly-diagnosed wet AMD were enrolled along with 15 age-matched control eyes with dry AMD. All patients were followed by sequential macular imaging utilizing the RTVue® SD-OCT (Optovue, Inc., Fremont, CA) for a minimum of six months. Macular GCC thickness was defined as the combination of retinal nerve fiber, ganglion cell and inner plexiform layers. Measurements between the two groups were made at the initial and most recent follow-up exams. Eyes with a history of glaucoma or macular edema affecting the GCC were excluded.

 
Results
 

Average follow up for all patients was 22.1± 9.0 months .The treatment group received on average 11.5 injections. A decrease in the average GCC thickness was found across the parafoveal region (inner 3 mm) of 9.3±10.7 um and 1.5±4.3 um in the treatment and control groups respectively (p<0.05). A significant correlation was found between the number of injections and the average amount of GCC thinning in the parafoveal (r = 0.495, p < 0.05) and the perifoveal (r = 0.431, p < 0.05) regions, principally in the nasal and temporal quadrants.

 
Conclusions
 

Ranibizumab and bevacizumab can lead to significant GCC thinning over time that correlates with the number of injections. This may account for lack of visual improvement in some patients. Further large scale prospective studies are needed to validate these findings.

 
 
Figure 1: Comparison of the average change in GCC thickness between the treatment and control groups in the parafoveal region.
 
Figure 1: Comparison of the average change in GCC thickness between the treatment and control groups in the parafoveal region.
 
 
Figure 2: The correlation between the average change in GCC thickness and the number of injections in the parafoveal region.
 
Figure 2: The correlation between the average change in GCC thickness and the number of injections in the parafoveal region.
 
Keywords: 585 macula/fovea • 695 retinal degenerations: cell biology • 550 imaging/image analysis: clinical  
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