SCIENTIFIC POSTER 2016_Response of Pigment Epithelial Detachment to Anti-VEGF Treatment in AMD Han Joo Cho

Objective:

To evaluate the therapeutic response of pigment epithelial detachment (PED) to anti-vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (nAMD), and identify predictive factors for PED resolution after treatment.

Methods:

A total of 202 treatment-naive nAMD eyes presenting PED at baseline were retrospectively included. All patients were treated with an initial series of three monthly loading injections of ranibizumab or aflibercept, followed by further injections as required. Features of PED assessed by fluorescein angiography (FA), indocyanine angiography (ICGA), and spectral domain optical coherence tomography (SD-OCT) were evaluated after treatment and correlated with visual outcomes.

Results:

After 12 months of treatment, the mean PED height decreased from 453 ± 261 µm at baseline to 230 ± 142 µm (P=0.002), and the mean BCVA improved from 0.71 ± 0.41 logarithm of the minimum angle of resolution (Snellen equivalent; 20/102) to 0.60 ± 0.36 (20/79) (P=0.024). The proportion of complete PED resolution after treatment was 19.3% (39 eyes). Multivariate logistic regression analysis was used to find baseline characteristics associated with a higher chance of PED resolution, including lower PED height at baseline (odds ratio [OR], 0.911; 95% confidence interval [CI], 0.812-0.942; P = 0.018), polypoidal choroidal vasculopathy (OR, 1.976; 95%CI, 1.130-4.226; P = 0.015) or retinal angiomatous proliferation (OR, 6.778; 95%CI, 3.181-17.216; P = 0.010) compared to typical nAMD, serous PED (OR, 9.129; 95%CI, 6.228-22.124; P = 0.022) compared to fibrovascular PED, and aflibercept (OR, 1.233; 95%CI, 1.036-2.443; P = 0.039) compared to ranibizumab.

Conclusions:

PEDs secondary to nAMD showed significant functional and anatomic improvement after intravitreal anti-VEGF injections over 12 months. However, the anti-VEGF treatment showed limited efficacy for the complete resolution of PED. The PED type, nAMD subtype, baseline PED height, and anti-VEGF drug type was associated with a higher probability of PED resolution after treatment.

Contact Details:

Email: ccnnrr@naver.com
Cell Phone: +821087715279

Han Joo Cho