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Kwang-Soo Kim, Jung Yeob Han; Effect of intravitreal anti-vascular endothelial growth factor injection in drusenoid pigment epithelium detachment progressed to wet age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2017;58(8):426.
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To evaluate the effect of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection in eyes with wet age-related macular degeneration (AMD) secondary to drusenoid pigment epithelium detachment (PED).
Nineteen eyes (nineteen patients) which had drusenoid PED with choroidal nevascularization were included in this study. Eyes had undergone intravitreal anti-VEGF injection on pro re nata schedule and followed-up for over 12 months. Best corrected visual acuity (BCVA) check and optical coherence tomography (OCT) for central macular thickness (CMT), height of subfoveal subretinal fluid (sSRF) and subfoveal drusenoid PED (sPED) were done at each visit. Factors which influenced final findings were analyzed using Wilcoxon signed rank test and multiple regression test. The eyes were divided into 3 groups according to the macular morphology by OCT: with intraretinal cystic edema (Group A, 4 eyes), with SRF (Group B, 8 eyes) and with mixed type (Group C, 7 eyes). Also the eyes were divided into 2 groups: continuous treatment group (9 eyes) and late observation group (10 eyes). Subgroup analysis was done using Kruskal-Wallis test.
The mean age of the patients was 67.84±7.35years. The mean follow-up period was 48.16±35.92months and the mean number of injections was 7.68±5.61. The initial BCVA(logMAR) was 0.56±0.30, and the mean pre-injection CMT, sSRF and sPED height was 129.95±35.13, 84.63±108.19μm and 172.21±121.83μm, respectively. The post-injection sSRF height showed a significant decrease (p=0.049), but there was no significant change in post-injection VA, sPED and CMT. Final BCVA was better when the number of injection was high (p=0.010) and the initial VA was better (p=0.047). Improvement of VA was greater in younger age (p=0.017) and with high number of injection (p=0.003). In subgroup analysis, VA improvement showed greatest in group C and less in group B (p=0.009). Continuous treatment group showed greater initial PED height (p=0.035) and mean change of CMT (p=0.043) than late observation group.
Wet AMD secondary to drusenoid PED showed better outcomes in eyes with better intial VA and showed relatively good response to anti-VEGF injection. OCT morphologically different types affect prognosis of the disease. When initial PED height is higher, there is tendency to maintain treatment.
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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