Purpose:
VEGFR2 has been involved in retinal neuroprotection. We showed the effect of anti VEGF therapy on GCC (ARVO 2010). The purpose of our study was to evaluate the structural damage of the GCC measured with FD-OCT in patients undergoing anti VEGF therapy for exudative AMD in comparison with control.
Methods:
A cross sectional observational study, 13eyes from 12 patients diagnosed with exudative AMD between 2008-10 were enrolled along with 6 control (fellow) eyes with dry AMD. Eyes with significant macular edema were excluded to eliminate any possible effect on GCC unrelated to actual cell loss. All patients were treated with either Ranibizumab or Bevacizumab and followed for at least one year. Macular mapping of the inner 5 mm in 8 sectors surrounding the fovea was obtained at diagnosis and at least one month after the last injection. GCC thickness was than measured from the internal limiting membrane to the inner retinal layer.
Results:
There was an average decrease of 13.76 microns across all measurement locations in the GCC thickness in treated eyes compared to an average decrease of 3.22 microns in control eyes. The treated group received on average 10.5 injections. Follow-up averaged 23.6 months in the treated group and 18.1 months in the control group. There was a significant correlation between the number of injections and the amount of GCC thinning in the peripheral measures (between 1.5-2.5mm from fovea) in the average peripheral thickness (r = 0.643, p < 0.02) and the inferior (r = 0.56, p < 0.05), temporal (r = 0.72, p < 0.01) and nasal (r = 0.643, p < 0.02) peripheral sectors.
Conclusions:
Anti VEGF therapy affects the retinal ganglion cells with GCC thinning that correlates with the number of injections especially in the first few injections. The effect on visual function is still unknown. Additional studies with larger sample sizes are needed to validate these findings.
Keywords: age-related macular degeneration • vascular endothelial growth factor • imaging/image analysis: clinical