Abstract
Purpose :
The purpose of this study was to compare the therapeutic effects of a high-dose (0.7 mg of ranibizumab and 2.8 mg of aflibercept) and a regular-dose (0.5 mg of ranibizumab and 2.0 mg of aflibercept) regimen and the changes in the intraretinal layer thickness during anti-VEGF injections in patients with exudative AMD.
Methods :
Patients were included in this study if they had exudative AMD and had received at least three injections of ranibizumab and/or aflibercept with a minimum of 24 months of follow-up with spectral-domain optical coherence tomography using rescan mode.
We divided patients into the regular-dose (RD) and high-dose (HD) groups. Patients in the RD group received a regular dose of intravitreal anti-VEGF injections, whereas patients in the HD group received a high dose of intravitreal anti-VEGF injections.
The paired t- test was used to compare the BCVA, IOP, and the retinal thickness values at baseline and each evaluation point in both groups. Comparisons of characteristics, including retinal thickness, between the RD and HD groups were performed using the Mann-Whitney U test.
Results :
The mean BCVA, IOP, CMT, RNFL thickness, and GC-IPL thickness at 1 month after the loading injection and at the final visit showed no significant intergroup differences at both time points. In both groups, the BCVA, IOP, and RNFL thickness at both time points did not differ significantly from the corresponding baseline values.
However, in the RD group, the final CMT and GC-IPL thickness were significantly thinner than those at the baseline. In the HD group, the final CMT and GC-IPL thickness were also significantly thinner than those at the baseline.
The two groups showed no significant differences in the changes in CMT, RNFL thickness, and GC-IPL thickness during intravitreal anti-VEGF treatment.
Conclusions :
In conclusion, in patients with exudative AMD who underwent repeated anti-VEGF treatment, RNFL thickness was well preserved during the follow-up period. However, the patients showed decreased GC-IPL thickness, suggesting that this was the effect of transsynaptic degeneration of ganglion cell dendrites with photoreceptor loss or that the retinal photoreceptors were chronically hypoperfused and ischemic from microvascular choroidal damage
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.