GOOD VISUAL OUTCOME AT 1 YEAR IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION WITH PIGMENT EPITHELIUM DETACHMENT: Factors Influencing the Treatment Response.

Abstract

PURPOSE:

To evaluate baseline and treatment factors influencing the response of pigment epithelial detachment (PED) in patients with treatment-naive neovascular age-related macular degeneration after 1 year of intravitreal anti-vascular endothelial growth factor treatment.

METHODS:

This retrospective consecutive case series study included 104 eyes (94 patients) with treatment-naive neovascular age-related macular degeneration and associated PED >150 μm treated with aflibercept (n = 41) or ranibizumab (n = 63) for at least 1 year. Stepwise linear regression was used to assess factors influencing best-corrected visual acuity and PED response.

RESULTS:

At 1 year, the best-corrected visual acuity improved from 20/63 (60.8 ± 15.9 Early Treatment of Diabetic Retinopathy Study letters) at baseline to 20/40 (69.0 ± 15.0 letters) (P = 0.001), and PED maximal height decreased from 370.8 ± 205.6 μm to 238.8 ± 178.5 μm (P = 0.001). Multivariate analysis revealed an association of the visual improvement with lower best-corrected visual acuity at baseline (P = 0.001), the presence of foveal subretinal fluid (P = 0.001), and female gender (P = 0.047). Pigment epithelial detachment height reduction was dependent on higher baseline PED height (P = 0.001) and treatment drug (P = 0.008).

CONCLUSION:

Visual improvement in neovascular age-related macular degeneration with PED was equally achieved with ranibizumab and aflibercept, influenced mainly by baseline best-corrected visual acuity and foveal subretinal fluid. Pigment epithelial detachment height reduction was influenced by baseline height and the treatment drug, favoring aflibercept for a stronger effect. The clinical significance of this result warrants further studies.

• Authors: Sophie de Massougnes, Ali Dirani, Irmela Mantel
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 38 Issue 4 Pg. 717-724 (Apr 2018) ISSN: 1539-2864 [Electronic] United States
• PMID: 28368974 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Recombinant Fusion Proteins
• Vascular Endothelial Growth Factor A
• aflibercept
• Receptors, Vascular Endothelial Growth Factor
• Ranibizumab

Topics

• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (therapeutic use)
• Choroidal Neovascularization (drug therapy)
• Female
• Humans
• Intravitreal Injections
• Male
• Middle Aged
• Ranibizumab (therapeutic use)
• Receptors, Vascular Endothelial Growth Factor (therapeutic use)
• Recombinant Fusion Proteins (therapeutic use)
• Regression Analysis
• Retinal Detachment (drug therapy, physiopathology)
• Retinal Pigment Epithelium (pathology)
• Retrospective Studies
• Vascular Endothelial Growth Factor A
• Visual Acuity (physiology)
• Wet Macular Degeneration (drug therapy, physiopathology)