Central retinal thickness fluctuations in patients treated with anti-VEGF for neovascular age related macular degeneration. Issue 4 (July 2022)

• Record Type: Journal Article
• Authors: Ciucci, Francesco; Ioele, Giuseppina; Bardocci, Antonio; Lofoco, Giorgio; Antonelli, Barbara; Gaetano, Cristiano De; Polimanti, Gabriele; Luca, Michele De; Ragno, Gaetano; Gattegna, Roberto
• Is Part Of: European journal of ophthalmology. Volume 32:Issue 4(2022)
• Page Start: 2388
• Page End: 2394
• Publication Date: 2022-07
• Subjects: Central retinal thickness -- foveal center point thicknesses -- principal component analysis -- fluctuations -- nAMD -- anti-VEGF; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; 617.7005
• DOI: 10.1177/11206721211037820
• Languages: English
• ISSNs: 1120-6721

Abstract

Purpose: This is a retrospective, single-center, non randomized interventional real life study, investigating the correlation between variability of central retinal thickness (CRT) and functional outcomes during 2 years of anti-VEGF therapy in patients treated for neovascular age related macular degeneration (nAMD). Background: CRT fluctuations can depend on various factors such as the correct timing of injections, the therapeutic algorithm, and the number of injections (NI) performed; it is important to understand if CRT fluctuations are responsible for worse visual outcomes and consequently to identify the correct ways to avoid or reduce them. Methods: Forty-one patients were treated for nAMD with aflibercept: 0.5 mg intravitreal aflibercept was administered every 4 weeks during the first 3 months, then bimonthly over the first year, and after the first year adopting a PRN regimen. Standard deviation of CRT (CRT/SD), BCVA, and NI were recorded. Correlation studies were performed by Pearson's test, Ancova, and Principal Component Analysis. Results: A negative correlation was found between CRT/SD and final BCVA. In patients who lost more than 15 letters, CRT/SD mean was significantly higher in comparison with patients who lost less than 15 letters. Patients with final BCVA >65 letters showed lower CRT/SD values compared to patients with final BCVA ⩽65 letters. Multivariate analysis confirmed that in patients with higher baseline BCVA, improvement of BCVA was correlated to NI, and lower values of CRT fluctuations were observed. Conclusions: CRT fluctuations, even after an appropriate NI given per year, significantly influence BCVA; a proactive treatment algorithm appears crucial when treating patients with nAMD.