July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Associations between variation in retinal thickness and visual function
Author Affiliations & Notes
  • Rebecca Nicole Evans
    Bristol Medical School, University of Bristol, United Kingdom
  • Usha Chakravarthy
    Institute of Clinical Science, The Queen’s University of Belfast, Ireland
  • Barney Reeves
    Bristol Medical School, University of Bristol, United Kingdom
  • Footnotes
    Commercial Relationships   Rebecca Evans, None; Usha Chakravarthy, Allergan advisory board (F), Apellis advisory board (F), Bayer advisory board (F); Barney Reeves, None
  • Footnotes
    Support  The National Institute for Health Research (NIHR) UK Health Technology Assessment (HTA) Programme funded the IVAN trial (ref: 07/36/01)
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3456. doi:
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      Rebecca Nicole Evans, Usha Chakravarthy, Barney Reeves; Associations between variation in retinal thickness and visual function. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3456.

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

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Purpose : To investigate whether visual outcome in eyes with neovascular age-related macular degeneration (AMD) is influenced by fluctuations in retinal thickness. We hypothesized that patients who experienced greater variation in retinal thickness over time when treated with anti-VEGF drugs for nAMD had worse visual outcome than patients who experienced less variation

Methods : Foveal centre point retinal thickness (CPT) was measured on optical coherence tomograms at quarterly intervals during the IVAN trial and monthly during the CATT trial, from baseline to 24 months. We extracted foveal CPT in all IVAN (n = 546) and CATT study participants (n =1165) after excluding those who did not have an exit visit with imaging or had 3 or less CPT measurements. For each participant we standardized the CPT (S-CPT) to allow for the different OCT instruments. The standard deviation (SD) of each participant’s S-CPT was calculated. Participants were grouped by quartile of S-CPT SD. Best corrected visual acuity (BCVA) at final visit and change from baseline to final visit were compared by quartiles of S-CPT for allocations to drug and treatment regimen. Linear regression was then used to examine the relationship between S-CPT quartile and BCVA at final visit, adjusting for baseline BCVA and original trial allocations.

Results : IVAN and CATT data were available on 1711 participants. Median S-CPT was 0.55 (interquartile range, 0.37, 0.84) in the IVAN cohort and 0.41 (0.26, 0.63) in the CATT cohort. Mean BCVA at the final visit was 73.2 (SD, 14.2) letters in participants in the lowest quartile of S-CPT (least variation in retinal thickness) and 59.4 (SD, 21.3) to those in the highest quartile of S-CPT (most variation). The adjusted regression model after adjustment for baseline BCVA and trial allocations confirmed a statistically significant trend across the quartiles of S-CPT (p<0.001), spanning a difference of >5 letters between first and fourth quartiles.

Conclusions : These preliminary analyses found that variation in retinal thickness in eyes receiving treatment for nAMD is adversely associated with visual outcome. Work is ongoing to explore whether the variation in retinal thickness is also associated with morphological outcomes such as the presence of fibrosis.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.



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