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X. Sun, G. A. Lalwani, A. E. Fung, S. Michels, S. R. Dubovy, C. A. Puliafito, W. J. Feuer, P. J. Rosenfeld; Correlations Between Changes in OCT Central Retinal Thickness and Visual Acuity in the PrONTO Study. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4578.
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In the PrONTO study, patients were treated with 3 consecutive monthly injections of Lucentis (ranibizumab) followed by retreatment as needed based on an OCT-guided variable dosing regimen. Overall, mean visual acuity improved by 9.3 letters at 1 year with 35% of patients gaining at least 15 letters. This improvement was achieved with an average of only 5.6 injections over the first year. We analyzed the data to determine if the decrease in OCT central retinal thickness measurements correlated with the improvements in visual acuity during the first year.
Visual acuity assessments and OCT central retinal thickness measurements were performed at baseline and monthly thereafter. Visual acuity letter scores were determined using a standard protocol refraction with the ETDRS chart at 2 meters. The central 1 mm OCT central retinal thickness measurements were obtained from the macular thickness maps calculated from the 6 low resolution diagonal scans once appropriate boundaries were confirmed. The influence of OCT central retinal thickness changes on visual acuity changes from baseline were assessed with both Pearson correlation and Spearman non-parametric correlation analyses.
At one month, there were no statistically significant correlations between the decrease in central retinal thickness and the improvement in visual acuity (Pearson, r=0.25, P=0.12; Spearman, r=0.23, P=0.15). However, after the first month, statistically significant correlations were observed between the decrease in central retinal thickness at 1 month and the improvements in visual acuity seen at 2 months (Pearson, r=0.57, P<0.001; Spearman, r=0.47, P=0.002), 3 months (Pearson, r=0.51, P=0.001; Spearman, r=0.36, P=0.021), and every subsequent month through Month 12 (Pearson, r=0.37, P=0.019; Spearman, r=0.38, P=0.015).
The initial OCT response to Lucentis therapy appears to be correlated with future visual acuity improvements. Additional correlation analyses will be presented through 24 months of the study.
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