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Manuel Hermann, Vasilena Sitnilska, Philip Enders, Sascha Fauser, Lebriz Altay; Dynamics of hyperreflective foci shortly after anti-VEGF treatment in neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3232.
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To evaluate the dynamics of hyperreflective foci (HF) in the first three weeks following injection of anti-VEGF agents for neovascular age-related macular degeneration (nAMD).
This study is a post-hoc analysis of the prospective observational study EIFU (Early intensified follow-up) performed at the Center of Ophthalmology of the University of Cologne (German Clinical Trial Register DRKS00010061). This study included 47 patients with active choroidal neovascularization secondary to nAMD treated with anti-VEGF (vascular endothelial growth factor). Spectral-domain optical coherence tomography (Spectralis OCT, Heidelberg Instruments) was performed at baseline (before treatment) and one, two and three weeks after treatment. The absolute number of HF was assessed for each measurement within the 3000 µm grid in outer nuclear layers and in photoreceptor complex employing a standardized protocol with repeated measurements by multiple observers. Statistical analysis was based on repeated measures analysis of variance (rmANOVA) followed by post-hoc paired samples t-tests (IBM SPSS 23).
Complete data sets could be obtained from 45 patients (mean age 76.0 ± 7.0 years, 28 female). The rmANOVA revealed a significant effect of therapy (F(3,132)=9.9; p<0.00001). Post hoc paired samples t-tests showed a statistically significant drop of mean HF from baseline (25.93 ± 21.5) to week one (19.0 ± 15.0) (p=0.003) which remained significant at week two (18.5 ± 16.4) and week three (16.5 ± 14.0) (both p<0.001). However the further drop of mean HF after week 1 did not reach statistical significance (all p >0.1).
This study describes the rapid dynamics of HF in nAMD within the first week after VEGF suppression in nAMD-patients. Our data suggest that HF could be a useful non-invasive imaging biomarker reflecting inflammatory disease activity.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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