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A. H. Kashani, P. A. Keane, S. R. Sadda; Correlation of Visual Acuity Outcomes With OCT Measurements of the Outer Nuclear Layer and Intraretinal Cysts in Neovascular AMD Before and After Treatment With Ranibizumab. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5577. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To quantify the outer nuclear layer (ONL)and intraretinal cystic spaces in patients with age-related macular degeneration (AMD) and determine if these parameters correlate with visual outcomes in patients that were treated with ranibizumab.
Images were obtained using the Radial Line protocol of 6 high-resolution B-scans on a single StratusOCT machine. Graded spaces included intraretinal cystic spaces when present, the ONL, and the whole neurosensory retina. Thickness and volume of each space was calculated for 9 standard ETDRS subfields and foveal center point. Univariate and multivariate analysis (GEE, SAS) was used to correlate OCT parameters with visual acuity at baseline, 6, and 9 months post-ranibizumab injection.
Demographic characteristics of the population included 18% males with an average age of 78±6 years (mean±SD). Data here are reported for all 9 ETDRS subfields. Mean intraretinal cyst thickness and volume were 4.71±8.11µm and 0.35±1.13mm3, respectively. Mean ONL thickness and volume were 114.7±27.6µm and 3.24±0.78mm3 respectively. Mean ONL thickness and volume excluding cystic spaces were 110±24µm and 2.89±1.37mm3. Mean retinal thickness and volume were 265.4±33.2µm and 7.50±0.94mm3 respectively. In a univariate linear regression model using adjusted R2 values, ONL thickness was significantly correlated with logMAR visual acuity at baseline and 6 months (R2=0.11, p=0.04 at baseline and R2=0.12, p=0.05 at 6 months), though the correlations were small. ONL volume was also significantly correlated with logMAR visual acuity at baseline and 6 month time points (R2=0.11, p=0.04 at baseline and R2=0.12, p=0.05 at 6 months). Overall retinal thickness was also significantly correlated with visual acuity at baseline and 6 months (R2=0.19, p=0.02 at baseline and R2=0.14, p=0.05 at 6 months). None of the OCT parameters measuring overall retinal thickness, cystic spaces or ONL correlated significantly with 9 month visual acuity. In a multivariate linear regression analysis adjusting for ONL volume and retinal thickness no other variables were significantly correlated with visual acuity outcomes.
This study suggests that ONL thickness and volume are positively correlated with visual outcomes in patients receiving intravitreal ranibizumab for neovascular AMD. However, this correlation likely only accounts for a small component of those visual outcomes.
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