Abstract
Purpose:
To analyze the vitreo macular interface (VMI) in VEGF inhibited patients and to investigate if VMI change has an effect on the treatment response.
Methods:
We performed a retrospective, observational, clinical study. Neo vascular age macular degeneration (NVAMD), exudative diabetic maculopathy (DME) and retina vein obstruction (RVO) with macular edema were studied. Three VMI groups were identified, vitreo macular adhesion (VMA), vitreo macular partial detachment (VMPD) and vitreo macular detachment (VMD). Patients diagnosed with fundus fluorescein angiography and serial spectral domain OCT (SD OCT) scans were included. Patients with a history of vitrectomy were excluded. Patients with VMA but who later developed VMD were included. Generalised linear models and repeated measures ANOVAs were used to evaluate the effect of diagnosis and VMI types on outcome measures, VA and CMT with adjustments for confounding and multiple testing (Bonferroni).
Results:
93 eyes of 85 patients treated with anti VEGF therapy for wet AMD (55 eyes), DME (18) and RVO (20) were identified. The median age of patients with NVAMD, RVO and CIDME were 70.77, 59.29 and 33 respectively. The distribution of VMA, VMPD, VMD in wet AMD, RVO, DME were, 3,3,49; 5,2,10 and 6, 2, 7 respectively. Six patients changed from VMA to VMPD. The CMT was significantly (p=0.05) reduced in the three disease categories and variable between the VMI types with AMD with VMA having the most significant (p=0.03) reduction. There was no statistically significant difference in VA between VMI groups.
Conclusions:
VMI may contribute to response to anti VEGF in AMD.