Abstract
Purpose :
We assessed the efficacy of vitrectomy and inner limiting membrane (ILM) peeling, followed by anti-vascular endothelial growth factor (VEGF) therapy, in anti-VEGF-resistant age-related macular degeneration (AMD), due to vitreomacular traction (VMT) or epiretinal membranes (ERM).
Methods :
We identified 6 patients with anti-VEGF-resistant AMD, due to VMT or ERMs, amongst 588 AMD patients (821 eyes) referred to Okayama University Hospital between February 2012 and May 2014. These patients underwent vitrectomy, which released the VMT (4 cases) or removed the ERM (2 cases), and ILM peeling. The regime used for intravitreal injections of anti-VEGF reagents after surgery was based on the severity of exudative changes in each patient. Preoperative and postoperative best-corrected visual acuities (BCVAs) and central retinal thicknesses (CRT) were compared.
Results :
After vitrectomy and ILM peeling, all 6 patients responded to anti-VEGF therapy, and its use then maintained dry retinas. Mean BCVAs had not improve significantly (0.49 ± 0.28 before versus 0.43 ± 0.38 after surgery, P=0.538). However mean CRTs had significantly reduced after surgery, from 423 ± 83.5μm to 257 ± 75.8μm (P=0.0078).
Conclusions :
Vitrectomy and ILM peeling, following by anti-VEGF therapy, may be a useful therapeutic option for anti-VEGF-resistant AMD, with VMT or ERMs.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.