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D. J. Jeng, S. R. Sadda; Commonly Evaluated Optical Coherence Tomography Features Are Not Predictive of Number of Anti-VEGF Injections in Neovascular Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2010;51(13):534.
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To identify features on optical coherence tomography (OCT) that are predictive of the number of injections required over the initial 12-months of anti-VEGF therapy in age-related macular degeneration (AMD).
A retrospective comparative case series was performed on 72 eyes treated with anti-VEGF therapy (bevacizumab or ranibizumab) at a single clinical site for neovascular AMD. Eyes with pre- and post-treatment OCT with 12 months follow-up were evaluated. Statistical analysis evaluating the number of injections received by an eye with certain OCT features was performed to identify if any characteristics were predictive of fewer injections.
The average number of injections received by 72 eyes over the first 12 months was 4.81. Eyes with a large amount of sub-retinal fluid received an average of 5.13 injections, and those with a small amount received 4.71 (p=0.48). No statistical significance was noted for patients with PEDs containing serous fluid or with the presence of fibrinous exudation (5.04 and 4.61, respectively; p=0.50). There also was no difference between eyes with large and small PEDs (5.32 and 4.80, respectively; p=0.36). There was a trend towards increased injections with the presence of CME (5.39 with CME, 4.42 without; p=0.14). Additionally, the presence of sub-retinal tissue did not affect the number of injections received (4.42 with, 5.02 without; p=0.42). Those eyes that responded to the first 3 treatments of anti-VEGF therapy seemed to require fewer injections than those that did not respond (4.17 and 5.5, respectively; p=0.04).
Commonly evaluated OCT features such as amount of sub-retinal fluid, fluid signal within PED, size of PED and presence of CME were not significant predictors of number of treatments in this study. However, response to initial therapy seemed to portend fewer overall treatments in the first 12 months.
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