Abstract
Purpose :
Anti VEGF agents are reported to affect the choroidal vasculature with reduction in CCST and progression to atrophic AMD.
Differentiating the iatrogenic effect from natural history of AMD is difficult and also if there is a difference between aflibercept and ranibizumab.
Short-term CCST changes could be more reflective of iatrogenic effect given the temporal pharmacodynamics of these drugs. This hypothesis, and inter agent variation, was investigated in this study.
Methods :
A retrospective case and image review was conducted. Patients with wet AMD and anti-VEGF naïve managed with a treat and extend protocol with three monthly induction doses with either aflibercept or ranibizumab were selected. CCST was measured at the primary, 3 and 6 month visits.
The CCST measurements were made from SD-OCT scans acquired on the Heidelberg Spectralis and were taken sub-foveal and 1500 microns from the fovea on the temporal and nasal horizontal plane. CCST was measured from the RPE reflectance line to the outer choroidal reflectance line.
The visual acuity and IOP measurements obtained were also recorded. Snellen acuities were converted to LogMar letter scores for statistical analysis. Patient with diabetes, CSR, PCV or other retinal vasculopathies including RVO/ RAP were excluded.
Results :
96 eyes (aflibercept n=45 and ranibizumab n=51) of 87 patients were included. The mean age and IOP for the aflibercept and ranibizumab was 73.37±12.6, 12.47±3.7 and 75.44±13.47, 13.61±3.89
There was a significant (p<0.0001) decrease in CCST from all three base line measurements for both aflibercept and ranibizumab at three months and six months.
A repeated measures analysis of variance of three and six month did not show a statistically significant difference between aflibercept and ranibizumab in the central (p=0.33), nasal (p=0.29) or temporal (p=0.40) CCST measurements.
Conclusions :
Aflibercept and Ranibizumab treatment for wet AMD lead to a statistically significant reduction in CCST at 3 and 6 months.
There was no statistically significant difference between aflibercept and ranibizumab in his study.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.