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Lisa Jane Faia, Lawrence Ho, Michael Thomas Trese; Relationship of Posterior Vitreous Detachment to Frequency of Intravitreal Injection of Anti-Vascular Endothelial Growth Factor for Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):589.
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To investigate the possible role of the vitreous and its state in the treatment of neovascular age-related macular degeneration (AMD) with intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapies.
Prospective study of thirty-three patients undergoing treatment for neovascular AMD in which B scan ultrasonography and optical coherence tomography (OCT) were used to establish the presence or absence of a posterior vitreous detachment (PVD). The patients were then subsequently grouped and followed for 1 year while undergoing treatment. At the end of the year, the number of injections needed was calculated and the groups were compared.
Thirty-three patients met the criteria and were included in the analysis (Table 1). At the initial B scan and OCT, 18 patients had PVDs and 15 did not. At the 6 month B scan, 4 of those patients had converted to a PVD (22 patients in total with a PVD at the end of 1 year). Statistically, the two groups were found to be similar in comparison of age, sex, and eye involved. The average number of injections per group was 9.44 for the non—PVD group and 8.40 for PVD group ( p-value >0.05). The estimated odds for getting at least one injection was 2.05 times higher for the non-PVD group than for the PVD group (95 % confidence interval [0.365, 11.522]).
The presence of a vitreous separation may be a factor in the frequency of anti-VEGF injections required for neovascular AMD. Further research is warranted.
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