April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Continuity of the Photoreceptor Inner/outer Segment Junction and Visual Acuity in Anti-VEGF Therapy for Exudative AMD
Author Affiliations & Notes
  • David Xu
    Cole Eye Institute, Cleveland Clinic Health System, Cleveland, Ohio
  • Sumit Sharma
    Cole Eye Institute, Cleveland Clinic Health System, Cleveland, Ohio
  • Siya Huo
    Cole Eye Institute, Cleveland Clinic Health System, Cleveland, Ohio
  • Jack Shao
    Dept of Ophthalmology, Case Western Reserve University, Cleveland, Ohio
  • Peter Kaiser
    Cole Eye Institute, Cleveland Clinic Health System, Cleveland, Ohio
  • Footnotes
    Commercial Relationships  David Xu, None; Sumit Sharma, None; Siya Huo, None; Jack Shao, None; Peter Kaiser, Carl Zeiss Meditec (R), Genentech (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 1760. doi:
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      David Xu, Sumit Sharma, Siya Huo, Jack Shao, Peter Kaiser; Continuity of the Photoreceptor Inner/outer Segment Junction and Visual Acuity in Anti-VEGF Therapy for Exudative AMD. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1760.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

To evaluate the continuity of the photoreceptor inner/outer segment (IS/OS) and thickness of the photoreceptor layer in patients with exudative age-related macular degeneration (AMD) and to investigate the relationship between IS/OS continuity, photoreceptor thickness, and visual outcome.

 
Methods:
 

A total of 99 eyes of 99 patients undergoing anti-vascular endothelial growth factor (anti-VEGF) monotherapy for exudative AMD were enrolled in this retrospective case series study. Anti-VEGF therapy was administered to patients on an as-needed basis guided by ophthalmic examination, visual acuity, and spectral domain optical coherence tomography (SD-OCT) findings. OCT scans were analyzed to extract measurements of retinal and photoreceptor morphology. Clinical measures were retrospectively analyzed to extract Snellen visual acuity, anti-VEGF injection history, and patient demographics.

 
Results:
 

The mean ± SD age was 80.7 ± 9.1 years. Patients underwent a mean of 11.2 ± 8.8 injections over 25.0 ± 17.6 months. At conversion to exudative disease, patients had a mean VA of .572 ± .379 (logarithm of the minimum angle of resolution [logMAR], 20/75 Snellen equivalent). At the time of study, patients had a mean VA of .487 ± .349 (logMAR, 20/60 Snellen equivalent). Age (p=.0390), photoreceptor thickness (p=.0323), baseline BCVA (p=.0046), and BCVA at time of study (p=.0001) were significantly different between patients with continuous and non-continuous IS/OS segment. More discontinuous IS/OS segment grading was associated with advanced age (p=.0390), thinner photoreceptor layer thickness (p=.0323), and worse baseline (p=.0046) and final (p=.0001) visual acuity. Advanced age (p=.0018) and decreased photoreceptor layer thickness (p=.0359) was correlated with worse final BCVA.

 
Conclusions:
 

Continuity of the photoreceptor IS/OS segment and increased photoreceptor thickness seen in SD-OCT are protective of visual acuity in patients undergoing anti-VEGF therapy for exudative AMD.

 
Keywords: age-related macular degeneration • photoreceptors • clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology 
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