Abstract
Purpose: :
To investigate the effects of three different drugs (Bevacizumab, Ranibizumab and Pegaptanib) on retinal morphology in three groups of patients with neovascular age-related macular degeneration (nAMD) using SD-OCT quantitative subanalysis.
Methods: :
In this retrospective study 60 eyes of patients with new-onset nAMD and treated with intravitreal injection of ranibizumab (20 eyes), pegaptanib (20 eyes) and bevacizumab (20 eyes) were examined. SD-OCT (Heidelberg engineering, Germany) scans were analyzed before and 4 weeks after anti-VEGF upload with 3 monthly intravitreal injections of ranibizumab (Group 1), 3 monthly intravitreal injections of bevacizumab (Group 2) and 2 six-weekly intravitreal injections of pegaptanib (Group 3). Quantitative (central retinal thickness)and qualitative (structural changes) measurements of the CNVs were analyzed and recorded using the Heidelberg Eye Explorer software.
Results: :
Central retinal thickness (CRT) decreased significantly in the 3 groups with mean reduction of 95 µ in Group1, 103 µ in Group 2 and 89 µ in Group 3, respectively. Presence of subretinal fluid or retinal cysts were reduced in 100% of eyes, with not significative differences between the groups. Analysis of pigment epithelium detachment (PED) showed decrease of serous PED in the 3 groups, with best results in Group 1 and Group 2 than Group 3. Tears of the RPE appeared in 1 eyes in Group 1 and 3 eyes in Group 2, not in Group 3.
Conclusions: :
In this SD-OCT study, the 3 anti-VEGF drugs determined similar morphological changes after loading regimen, in patients with new-onset nAMD. Quantitative subanalysis showed not significative differences in patients treated with ranibizumab and bevacizumab, when compared to those with pegaptanib significative differences were found in the reduction of fluid under RPE in serous PED.
Keywords: age-related macular degeneration • retinal neovascularization • vascular endothelial growth factor