CHOROIDAL IMAGING BIOMARKERS TO PREDICT HIGHLY RESPONSIVE AND RESISTANT CASES TREATED WITH STANDARDIZED ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR REGIMEN IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Jhingan, Mahima; Cavichini, Melina; Amador, Manuel; Dans, Kunny; Bartsch, Dirk-Uwe; Cheng, Lingyun; Chhablani, Jay; Freeman, William R.
• Is Part Of: Retina. Volume 41:Issue 10(2021)
• Publication Date: 2021-10
• Subjects: choroid -- choroidal thickness -- choroidal vascularity index -- predictor of response -- neovascular AMD -- wet AMD; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000003156
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To determine structural predictors of treatment response in neovascular age-related macular degeneration analyzing optical coherence tomography (OCT)–related biomarkers. Methods: A retrospective review of patients undergoing treatment for neovascular age-related macular degeneration at a tertiary institute was performed at presentation. High-intensity regimen included eyes on long-term anti–vascular endothelial growth factor treatment with the inability to extend beyond a month without a relapse and needed double the dose of medication (n = 25). Low-intensity regimen had eyes that went into long-term remission after at least three injections and remained dry for more than a year until the last visit (n = 20). Multimodal imaging including fluorescein angiogram, OCT, and comprehensive ocular evaluation were done. Choroidal vascularity index, total choroidal area, luminal area, subfoveal choroidal thickness, choriocapillaris thickness and Haller and Sattler layer thickness were analyzed for statistical significance. Results: The groups had no significant difference at baseline in age, gender, incidence of reticular pseudodrusen, polypoidal choroidal vasculopathy feature on OCT, type of choroidal neovascular membrane, and geographic atrophy. Multinomial logistic regression revealed that thicker subfoveal choroidal thickness and larger total choroidal area were the significant predictors of poor response to anti–vascular endothelial growth factor treatment (E = 0.02; P = 0.02; E = 1.82; P = 0.0075). Conclusion: Thicker subfoveal choroidal thickness and higher total choroidal area are useful variables to predict a poor treatment response. Abstract : This study is a retrospective review of patients with neovascular age-related macular degeneration. Optical coherence tomogram images were evaluated at baseline to look for predictors of response to standardized therapy. Thicker subfoveal choroidal thickness and higher total choroidal were found to be good predictors of poor response to treatment.