Spectral Domain Optical Coherence Tomography Evaluation of Macular Morphology Before and After Ranibizumab Treatment of Age-Related Macular Degeneration

Abstract

Purpose: : to determine the correlation between macular morphology and visual acuity of patients with exudative Age-related Macular Degeneration (AMD) treated with ranibizumab using Spectral Domain Optical Coherence Tomography (SDOCT).

Methods: : retrospective case series. Thirty-seven eyes of 36 consecutive patients treated with intravitreal ranibizumab were examined. SDOCT line foveal scans and retinal maps were obtained at baseline and after the loading phase. The morphology of the retinal lines corresponding to the External Limiting Membrane (ELM), IS/OS junction, retinal pigment epithelium (RPE), as well as the pathologic findings, i.e. hypereflective dots, hyper- or hyporeflective fluid and vitreoretinal alterations was graded as "normal or present": 1, or "absent or altered": 0. T-test and Chi-square test were calculated on: 1) bsl morphology and bsl logMAR visual acuity (VA); 2) final morphology and final VA; 3) bsl morphology and final VA.

Results: : at baseline, the IS/OS line was altered in almost all eyes (36/37). The association between bsl VA and ELM and RPE bsl integrity was statistically significant (p=0.05 and p=0.03 resp). After the loading phase, VA increased in 19 eyes, 12 were stable and 6 worsened (ANOVA analysis p=0,001). The association between final VA and final ELM and IS/OS integrity was statistically significant (p=0.03 and p=0.05 resp). When comparing baseline scans and final VA the only significant morphologic aspect is preserved EPR (p=0.04).

Conclusions: : although SDOCT appears to be a promising method to study the ultrastructural morphology of the retina, at baseline evaluation it shows only faint signs which might predict visual outcome in antiangiogenic therapy for AMD. Further investigation is needed to improve our prognostic capability on AMD treatment.

Keywords: age-related macular degeneration • imaging/image analysis: clinical • choroid: neovascularization