Refractory neovascular age-related macular degeneration: time-dependent changes of central retinal thickness with anti-V
- PDF / 2,623,455 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 12 Downloads / 184 Views
RETINAL DISORDERS
Refractory neovascular age-related macular degeneration: time-dependent changes of central retinal thickness with anti-VEGF treatment Marta Zola 1 & Elisa D’Alessandro 1 & Mohamed Sherif 1 & Audrey Nguyen 1 & Dominique De Azevedo 1 & Céline Haeller 1 & Edwige Forestier 1 & Irmela Mantel 1 Received: 28 June 2020 / Revised: 24 October 2020 / Accepted: 30 October 2020 # The Author(s) 2020
Abstract Purpose To assess the influence of time interval since last injection and time from baseline on central retinal thickness (CRT) in neovascular age-related macular degeneration (nAMD) with fluid refractory to monthly anti-VEGF treatment. Methods This retrospective study included nAMD eyes with incomplete response to anti-VEGF defined by the presence of intraor subretinal fluid on optical coherence tomography despite maximal (monthly) anti-VEGF dosing. The outcome measure was CRT, and two time variables (time from last injection ant time from baseline) were the independent factors included in the individual correlation analyses. In addition, an association analysis was performed. Results Sixty eyes of 56 patients (67.9% females, mean age: 78.7 ± 6.8 years) were included with a mean included time period of 35.6 months. A significant positive correlation between CRT and the time from last injection occurred in 24 (40%) and 25 (42%) eyes by univariate and multivariate analysis, respectively. Time from baseline was significantly correlated with CRT in 29 (48.3%) and 30 (50%) eyes by univariate and multivariate analysis, respectively. This correlation was positive in 12 (20%) and negative in 18 eyes (30%). No association with such correlation was found. Conclusion So-called refractory nAMD frequently shows a correlation of CRT with the interval in days from the preceding antiVEGF injection, revealing that there is a subgroup of short-term responsiveness of the residual fluid. Moreover, slower CRT changes may occur over the years, either decrease or increase. In case of a slow CRT increase, this might require a diagnostic workup and therapeutic change.
Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s00417-02005000-3. * Irmela Mantel [email protected] 1
Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Foundation Asile des Aveugles, Lausanne, Switzerland
Graefes Arch Clin Exp Ophthalmol
Key messages Patients undergoing intravitreal anti-VEGF injections for neovascular AMD and showing intra or subretinal fluid on optical coherence tomography despite maximal (monthly) treatment are considered refractory or incomplete responders. However, the influence of time on the amount of this fluid hasn’t been studied in detail. Our study found that the time interval between visit and the preceding injection significantly influenced the central retinal thickness (CRT) in 40% or more. These may be short term responders, and potentially benefit from more frequent injections. Studies about anti-VEGF refractoriness and CRT as end
Data Loading...
