Abstract
Purpose :
To analyze changes of mean photoreceptor layer thickness (PRT) on the ETDRS-Grid during the first year of anti-VEGF treatment in eyes with treatment naive neovascular age-related macular degeneration (nAMD) using deep-learning.
Methods :
Fifty-five eyes of 55 patients with newly diagnosed nAMD were included in this prospective study. After three loading doses of aflibercept, patients continued treatment according to the treat-and-extend regimen. Study examinations comprised best-corrected visual acuity and spectral-domain optical coherence tomography before (BSL) as well as 1 (M1), 2 (M2), 3 (M3), 6 (M6), 12 months (M12) and at each visit after treatment initiation. PRT (region between the inner limit of the ellipsoid zone and the inner interface of the retinal pigment epithelium), subretinal fluid (SRF), intraretinal fluid (IRF) and photoreceptor loss area (PRLA) were assessed using an automated algorithm. Changes in PRT and the effect of SRF, IRF, PRLA and number of injections were calculated with repeated measures linear mixed models and post hoc pairwise comparisons.
Results :
PRT at all follow-up visits was significantly reduced from BSL: 24,49±13,76µm at BSL to 16.14±7.93µm at M1, 17.02±7.83µm at M2, 17.49±7.23µm at M3, 17.44±7.14µm at M6 and 18.95±7.56µm at M12 in the 1mm disc area (all p-values ≤0.001); 24.83±8.33µm at BSL to 18.45±5.94µm at M1, 19.03±6.03µm at M2, 19.21±5.73µm at M3, 19.48±5.97µm at M6 and 20.04±5,42µm at M12 in the 3mm disc area (all p-values ≤0.004); 26.63±6,24µm at BSL to 21.66±5.01µm at M1, 22.07±5,20µm at M2, 22,22±4,95µm at M3, 22.49±5.07µm at M6 and 22.97±5,40µm at M12 in the 6mm disc area (all p-values ≤0.03). SRF was positively correlated with PRT and negatively correlated with PRLA in all disc areas (all p-values ≤0.02). IRF was negatively correlated with PRT and positively correlated with PRLA in the 6mm area (all p-values≤0.04). Number of injections was not significantly correlated with PRT or PRLA.
Conclusions :
Application of an automated algorithm across a 6mm grid with different sections of the macula allows for a comprehensive evaluation of important nAMD biomarkers, such as PRT, PRLA, SRF and IRF. PRT is significantly reduced after anti-VEGF treatment initiation up to 12 months in the 1mm, 3mm and 6mm disc area. SRF, IRF and PRLA are significantly correlated to PRT in the macula, whilst number of injections is not.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.