Abstract
Purpose :
To analyse the structural OCT biomarkers prior to Macular NeoVascularisation (MNV) and Visual Acuity (VA) outcomes in fellow eyes over a 5 year period for patients who have been initiated with Intravitreal injections in 2017
Methods :
A single-center, retrospective, observational study analyzed the fellow eye of patients receiving intravitreal injections (IVI) for nAMD in 2017. A total of 117 patients were initiated with IVI, out of which 48 patients were excluded (26 same year IVI, 9 previous IVI, 13 poor vision). Visual acuity and OCT were analyzed each year.
Out of the 69 patients without the presence of MNV at baseline, markers were analyzed for conversion to MNV (mainly prevalence of double layer sign (DLS), incidence of Shallow Irregular Retinal pigment Epithelial elevation (SIRE), drusenoid PED, and any other OCT biomarkers prior to MNV). Not all patients were analyzed at 5 years, as over time, some were deceased and others lost to follow-up.
In patients who developed MNV, OCT images prior to the development of MNV were analyzed, and the functional and structural outcomes were compared to their first eye receiving IVI.
Results :
69 patients were analyzed, and the incidence of nAMD after year 1 and within the 5-year period was 21.7% (15 patients). The mean VA and CMT of the fellow eye at baseline were 72.75 and 276.36, respectively, and at the end of the 5-year period, they were 67.57 and 284.25, respectively (Graph 1).
For the remaining 35 patients who had no features of MNV at the end of 5 years, the most common OCT structural change was DLS (16 patients), SIRE (6), drusenoid PED (8), and GA (8) (Graph 2).
Of all the patients who converted to MNV within 5 years, 14 patients had DLS at the baseline, which progressively increased in size, 4 patients had Drusenoid PED, 2 had SIRE, and 1 had GA.
The main OCT feature in our patients who converted to nAMD was a higher number of DLS.
Conclusions :
OCT structural biomarkers such as DLS and SIRE are useful for monitoring patients with a higher incidence of conversion to MNV. OCT features and early detection of MNV prove better visual improvement over the long term. A larger sample size and long-term follow-up are required to review progression
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.