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Alan J Franklin, Shalesh Kaushal; Central Choroidal Thickness is Significantly Diminished Following anti-VEGF Treatment for Neovascular Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4976.
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To determine whether there is a change in central choroidal thickness or volume after treatment of neovasscular age related macular degeneration with anti-VEGF agents.
Retrospective chart review of 25 patients who underwent at least 6 anti-VEGF treatments for neovascular age related macular degeneraton. Spectral OCT, Heidelberg Spectralis, was performed at the same time of day for both eyes. Central choroidal thickness and choroidal volume were determined by a masked reader for eyes treated with anti-VEGF agents and compared to the fellow untreated eye.
Spectral OCT analysis with enhanced depth imaging, Heidel Spectralis, was performed on 25 individuals who received at least 6 anti-VEGF treatments in a single eye for neovascular age related macular degeneration. Central choroidal thickness and volume were measured and compared between treated and untreated eyes. Central choroidal thickness was clearly diminished in eyes with AMD treated with anti-VEGF compared to the fellow untreated eyes that did not have signs of pathological neovascularization; Average choroidal thickness after treatment 163 micron vs. 201 microns for fellow untreated eyes, p = 0.0001, Students t-test. Choroidal volume was also significantly diminished. Numbers were not sufficient to demonstrate any differential effect of any single anti-VEGF agent upon choroidal attenuation compared to other anti-VEGF agents.
Central choroidal thickness is signifcantly and somewhat consistently reduced in individuals who receive multiple anti-VEGF injections for neovascular AMD compared to fellow untreated eyes without active neovascularization. Prolonged treatment with these anti-vascular agents are known to increase RPE degeneration and atrophy so that this observed choroidal attenuation suggests a mechanism that mediates the reported worsening atrophy following anti-VEGF treatment for neovascular AMD.
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