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Tina Ristau, Steffen Hillebrand, Dzenita Smailhodzic, Jared Updike, Alexander C. Walsh, Bernd Kirchhof, Srinivas R. Sadda, Sandra Liakopoulos; Prognostic Value Of SDOCT And Angiography For Visual Acuity Outcome After Ranibizumab In Patients With Neovascular AMD. Invest. Ophthalmol. Vis. Sci. 2011;52(14):144.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate whether spectral domain OCT (SDOCT) and fluorescein angiography (FA) findings are predictive of visual acuity (VA) after Ranibizumab therapy for neovascular AMD.
Best corrected VA of 72 previously untreated eyes with NVAMD were retrospectively collected at baseline, after 3 injections and at 12 months follow-up. CNV lesion components on FA were qualitatively and quantitatively analyzed using reading center software. SDOCT images were qualitatively (n=72) and quantitatively (n=62) evaluated using the manual grading software 3D OCTOR. Thickness was calculated for the spaces retina, photoreceptor layer, subretinal fluid, subretinal tissue and pigment epithelial detachment (PED). VA as well as change in VA from baseline were correlated with all parameters.
Lower VA at baseline significantly correlated with lower VA (R=0.7 after 3 injections / R=0.6 at 12 months) as well as greater increase in VA (R=0.3 after 3 injections /R=0.5 at 12 months).Eyes with RAP on FA showed a greater increase in VA after 3 injections than eyes with occult CNV without RAP. Greater area of the total CNV lesion correlated with lower VA after 3 injections (R=0.3) and at 12 months (R=0.5). Greater area of the classic CNV component correlated with lower VA after 3 injections (R=0.3) and greater area of the occult CNV component correlated with lower VA after 12 months (R=0.5).On SDOCT, eyes with cystoid spaces had lower VA after 3 injections than eyes without cystoid spaces. Greater retinal thickness correlated with greater VA increase after 3 injections (R=0.3). Greater thickness of subretinal tissue and a thinner photoreceptor layer correlated with lower VA after 3 injections (R=0.4; R=-0.4). Greater thickness of PED and a thinner photoreceptor layer correlated with lower VA at 12 months (R=0.4; R=-0.4).
Several parameters on FA and SDOCT images showed prognostic value for VA outcome after Ranibizumab in NVAMD. A larger, prospective dataset will be crucial for defining the relative importance of these parameters.
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