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Claudia Patricia Acosta, Carolina Sardi, Elisa Mejia, juan sanchez; Image biomarkers as predictors of response in patients using Ranibizumab in nAMD. Invest. Ophthalmol. Vis. Sci. 2017;58(8):392.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the association between the response to intravitreal Ranibizumab therapy and spectral domain OCT, fluorescein angiography , and fundus autofluorescence biomarkers, in patients with nAMD.
We evaluated the clinical charts of 83 nAMD patients, and selected two groups. The first group consisting of fifteen subjects that met the criteria for poor-responders, and the second group of 15 subjects that showed good respond to intravitreal Ranibizumab. Both groups were matched by gender and age. All patients had a comprehensive ocular examination. They underwent wide field fundus FA, wide field fundus FAF and EDI-SDOCT. The frequency of several image biomarkers was evaluated in both groups. The analysis had a descriptive emphasis. For quantitative variables, central tendency and dispersion measures were used; whereas, for qualitative variables, absolute and relative proportions were obtained. Chi squared test was used to compare proportions of some characteristics between good responders and poor responders.
At the OCT, the most frequent finding in the good responder group, was the presence of Subretinal fluid in 70,00% of the subjects, and the loss of the integrity of the ellipsoidal zone, in the poor responder group was observed in 73,33% of the subjects. A significant difference between both groups was found in: a) Presence of external tubulations (p=0,04); b) Presence of subretinal thickening (p=0,00); c) Presence of subretinal fluid (p=0,04), d) Presence of cysts content in the outer retinal layers (p=0,03), e) Presence of Fibrosis at the FA (p= 0,04) and f) Presence of an increase of the autofluoresce findings on the FAF (p=0,005). There was not statically significant difference on the peripheral findings (both, on FA and FAF) between the groups.
The following findings were correlated with a good respond to intravitreal Ranibizumab for nAMD: At the OCT: The absence of External tubulations, and/or subretinal thickening, and the presence of intraretinal fluid content to the outer retinal layers and/or the presence of subretinal fluid. On the FA: the absence of fibrosis. And on the FAF: the presence of an increase autofluorescence pattern.Identification of image biomarkers are very important in AMD, these biomarkers, plus initial visual acuity can be used as a guide for categorization of patients according to response expectation, and therefore tailor the follow up scheme.
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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