June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Changes of biomarkers in optical coherence tomography after different policies of treatments for neovascular age-related macular degeneration: a real-world comparative study
Author Affiliations & Notes
  • Yu-Shu Huang
    Ophthalmalogy, National Taiwan University Hospital, Taipei, Taiwan
  • Ta-Ching Chen
    Ophthalmalogy, National Taiwan University Hospital, Taipei, Taiwan
  • Tso-Ting Lai
    Ophthalmalogy, National Taiwan University Hospital, Taipei, Taiwan
  • Chung-May Yang
    Ophthalmalogy, National Taiwan University Hospital, Taipei, Taiwan
  • Tzyy-Chang Ho
    Ophthalmalogy, National Taiwan University Hospital, Taipei, Taiwan
  • Yi-Ting Hsieh
    Ophthalmalogy, National Taiwan University Hospital, Taipei, Taiwan
  • Chang-Hao Yang
    Ophthalmalogy, National Taiwan University Hospital, Taipei, Taiwan
  • Footnotes
    Commercial Relationships   Yu-Shu Huang, None; Ta-Ching Chen, None; Tso-Ting Lai, None; Chung-May Yang, None; Tzyy-Chang Ho, None; Yi-Ting Hsieh, None; Chang-Hao Yang, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4229. doi:
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    • Get Citation

      Yu-Shu Huang, Ta-Ching Chen, Tso-Ting Lai, Chung-May Yang, Tzyy-Chang Ho, Yi-Ting Hsieh, Chang-Hao Yang; Changes of biomarkers in optical coherence tomography after different policies of treatments for neovascular age-related macular degeneration: a real-world comparative study. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4229.

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

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Abstract

Purpose : Age-related macular degeneration (AMD) is one of the most common causes of severe visual loss in middle- and old-aged populations, often leads to severe impairments in daily life. Anti-vascular endothelial growth factor (anti-VEGF) agents have been the standard first-line treatment for neovascular AMD (nAMD) but, in real-world practice, different strategies may lead to different clinical results. This study evaluated the characteristic changes in optical coherence tomography (OCT) biomarkers in different health-insurance policies of anti-VEGF treatments and their relationship with visual outcomes at 1-year follow-up in real-world settings.

Methods : 62 eyes and 53 eyes with nAMD treated with intravitreal aflibercept before December, 2015 and during January, 2017 and December, 2018, were retrospectively reviewed the medical records including ophthalmologic examinations and spectral-domain OCT at baseline and months 3, 6, and 12 after first injection. Treatment response of intraretinal cysts, subretinal fluid, and pigment epithelial detachment (PED), and the correlation between best-corrected visual acuity (BCVA) changes and these OCT biomarkers were analyzed.

Results : For those who received treatments (group A) before Dec 2015, they had an average of 4.9 ± 1.5 injections within the first year, while an average of 6.0 ± 1.4 injections in those who received treatments between Jan 2017 and Dec 2018 (group B). In group A, 38% of eyes with pigment epithelial detachments showed resolution at month 12, lower than for intraretinal cysts (IRCs, 55%) or subretinal fluid (SRF, 52%). BCVA improvement at 1 year was negatively associated with PED both at baseline and at month 12. Persistence of IRCs at month 12 was associated with degeneration morphology of IRCs at baseline, non-resolved cysts at month 3, and poorer visual recovery. Statistically, almost all biomarkers got further improvement in group B compared to group A at month 12 except resolution of PED.

Conclusions : In conclusions, the change of health-insurance policies and the preferred protocols obviously influenced the clinical practice and outcomes of nAMD. Biomarkers reflect the non-invasive pathology of disease. IRCs and PED are associated with poor visual improvement in nAMD in a real-world setting, and PED seemed to be more insensitive to intense anti-VEGF therapy.

This is a 2020 ARVO Annual Meeting abstract.

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