Abstract
Purpose :
To examine the effect of multiple intravitreal injections with anti-vascular endothelial growth factor (anti-VEGF) on RNFL thickness in patients with diabetic macular edema (DME), exudative age-related macular degeneration (wAMD), and branch retinal venous occlusions (BRVO).
Methods :
This retrospective chart review included 322 patients who received anti-VEGF therapy. 39 patients met inclusion criteria, which consisted of >1 anti-VEGF treatment to one eye only, diagnosis of primary open angle glaucoma (POAG) or glaucoma suspect (GLS) to ensure optical coherence tomography (OCT) imaging, and an OCT of both eyes performed at least 6 months after initial treatment. The untreated, contralateral eye was used as the control. The unpaired two-tailed Student's t-test was used for statistical analysis.
Results :
The mean time between initial anti-VEGF treatment and OCT imaging was 53.1 months ranging from 6 to 144 months. 17 patients received treatment for DME, 16 for wAMD, and 6 for BRVO. Mean RNFL thicknesses for eyes receiving anti-VEGF injections (68.9 ± 13.1μm) were not statistically significant compared to untreated eyes (73.4 ± 14.4μm, p=0.15) regardless of treatment diagnosis. There was a significant difference in mean RNFL thickness between treated (65.3 ± 7.7μm) and untreated eyes (80.0 ± 4.2μm, p<0.05) for patients with BRVO; however, this was not true for patients treated for DME (treated 68.1 ± 15.3μm, untreated 71.1 ± 16.2μm, p=0.58) or wAMD (treated 71.2 ± 12.6μm, untreated 73.4 ± 14.7μm, p=0.65).
Conclusions :
Patients with POAG or GLS who received multiple intravitreal injections with anti-VEGF for DME, wAMD, and BRVO tended to have a thinner RNFL in the treated eye. This effect was only significant in patients with BRVO. BRVO may be associated with more RNFL tissue loss than DME and wAMD, but this result may also be explained by a small sample size.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.