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Tamara Mato Gondelle, Manuel F Bande, Laura Paniagua, María José Rodríguez Cid, Maximino Abraldes López-Veiga, Maribel Fernández Rodríguez, María José Blanco, Antonio Piñeiro; Ultrasonographic findings in vitreous of age-related macular degeneration patients treated with intravitreal anti-vegf injections. Invest. Ophthalmol. Vis. Sci. 2017;58(8):390.
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At the present, the main treatment of patients diagnosed with exudative AMD is repeated intravitreal injection of anti-VEGF following different protocols. The aim of this study was to assess the relationship between intravitreal injections of anti-VEGF and changes in vitreous ultrasonographic findings in patients with AMD
A retrospective and consecutive study was carried out in 34 patients (68 eyes) diagnosed with exudative AMD. The data included were: age, sex, number of injections in each eye of each patient and type of anti-VEGF (ranibizumab, aflibercept). Ultrasonographic findings were obtained by the same physician (MBR) in all cases. Ocular ultrasonographic exam was done using the AVISOTM, Ultrasound platform (Quantel Medical, Clermont-Ferrand, France). In all cases it was done with eyelids open, instillation of topical anesthesia and carbomers as ultrasonographic gel. Topographic, quantitative and kinetic ultrasonography was carried out in all quadrants of each eye by means of the 10MHz posterior pole probe. The vitreous reflectivity degree was studied by using ImageJ software (Open Source, Public Domain)
The mean age of the patients was 80 years old (range 59-94) with a mean of total intravitreal anti-VEGF injections of 5 (range 1-12). No ultrasonographic significant differences were found related to the incidence of posterior vitreous detachment (PVD), partial or complete, in all eyes included in the study. In most cases, vitreous hyperechogenicity was found to be increased in the treated eye (Mann-Whitney, p<0.001). Likewise, the average range of vitreous reflectivity increased proportionally with the number of vitreous injections (Spearman, p=0.03). However, the type of anti-VEGF used and the time elapsed since the last intravitreal injection did not modify this result (Mann-Whitney, p>0,05)
This is the first study to consider the characteristics of the vitreous gel after the chronic treatment of exudative AMD by means of repeated anti-VEGF intravitreal injections. Preliminary results indicate a proportional increasing in ultrasonographic reflectivity of vitreous gel, positively correlated with the number of injections. The authors believe that these findings should be correlated, in subsequent studies, with the type of anti-VEGF used and, especially, with the degree of BCVA recovered and/or the appearance of floaters
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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