July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
The Effect of Multiple Anti-VEGF Injections on Retinal Nerve Fiber Layer (RNFL) Thickness
Author Affiliations & Notes
  • Petar Yanev
    University of Texas Health Science Center San Antonio, San Antonio, Texas, United States
  • Chelsey Krambeer
    Medical Center Ophthalmology Associates, San Antonio, Texas, United States
  • Joshua Michael Iltis
    University of Texas Health Science Center San Antonio, San Antonio, Texas, United States
  • Aaron Mendlovitz
    Medical Center Ophthalmology Associates, San Antonio, Texas, United States
  • Michael Singer
    Medical Center Ophthalmology Associates, San Antonio, Texas, United States
  • Footnotes
    Commercial Relationships   Petar Yanev, None; Chelsey Krambeer, None; Joshua Iltis, None; Aaron Mendlovitz, None; Michael Singer, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5403. doi:
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      Petar Yanev, Chelsey Krambeer, Joshua Michael Iltis, Aaron Mendlovitz, Michael Singer; The Effect of Multiple Anti-VEGF Injections on Retinal Nerve Fiber Layer (RNFL) Thickness. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5403.

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      © ARVO (1962-2015); The Authors (2016-present)

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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.

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