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Konstantinos Balaskas, Michael Karampelas, Mania Horani, Oana Hotu, Tariq Aslam; Quantitative analysis of Pigment Epithelium Detachment response to anti-VEGF treatment in patients with Wet Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4944.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of the present work is to assess response of PEDs to anti-VEGF treatment by means of modern, customised image analysis tools that can provide quantifiable measures of response to treatment and thus may offer clues to guide management decision tailored to the individual needs of each patient
Consecutive patients from Manchester Royal Eye Hospital with Wet AMD associated with a PED were recruited retrospectively. A balanced sample of treatment-naïve patients on either aflibercept or ranibizumab was identified. A minimum PED height of 50 microns was defined for inclusion. Data recorded included: Best-corrected visual acuity (BCVA), CMT, presence of SRF/IRF, maximum PED height, PED horizontal dimension, PED vertical dimension, PED surface area, PED volume and PED content reflectivity by means of customised image analysis software.The same data were recorded at baseline, after three months (three injections of either anti-VEGF agent) and at the end of year one of treatment. A stepwise linear regression analysis was used to identify associations between change in BCVA and PED metrics and all baseline parameters.
102 consecutive patients were included into the study, 50 on ranibizumab and 52 patients aflibercept.Change in BCVA significantly associated only with baseline BCVA (p=0.002 at 3 months, p=0.001 at one year).Change in maximum PED height at 3 months was associated with baseline PED height (0.001) and use of aflibercept (p=0.026). At one year it was associated only with baseline PED height (0.001).Change in PED volume was associated only with baseline PED volume at 3 months (p=0.004) and with baseline PED volume (p=0.012), PED vertical section area (p=0.012) and PED orientation (p=0.043) at one year.PED reflectivity (pixel intensity) was associated with baseline values at 3 monhts (p=0.004) and one year (p=0.001) but also, interestingly, with aflibercept at 3 months. (p=0.01)
Change in BCVA in response to treatment is not associated with change in PED dimensions. All quantifiable PED metrics (including height, volume, width) improve in response to treatment, more so on aflibercept at 3 months and one year. The improvement is largely dependant on baseline values. PED content reflectivity is affected differently by different anti-VEGF agents.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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