High frequency SD-OCT follow-up leading to up to biweekly intravitreal ranibizumab treatment in neovascular age-related macular degeneration

Abstract

A remarkable proportion of neovascular age-related macular degeneration (nAMD) patients respond rather poorly to ranibizumab treatment, in spite of the minimum 4-week follow-up and treatment interval. Usually, retreatments are based on nAMD activity as evaluated by Spectral-domain Optical coherence Tomography (SD-OCT), biomicroscopic fundus examination and visual acuity changes. In this prospective pilot study, we aimed to study SD-OCT changes in a high-frequent follow-up manner (weekly (month 0–6), biweekly (month 7–12)) throughout the first year, which consequently led to intravitreal ranibizumab being administered up to biweekly. Best corrected visual acuity (BCVA) was already significantly improved at week 2. Central retinal thickness (CRT), intraretinal and subretinal fluid (SRF) were significantly improved from week 1 onwards. Half of the patients showed nAMD activity at week 2 or 3 and received the first retreatment earlier than 4 weeks after baseline injection. In total, 46% of retreatments were already applied 2 or 3 weeks after the previous treatment. Greater range of CRT and SRF fluctuation during follow-up was associated with lower final BCVA. Lower baseline BCVA and better SRF improvement at week 2 was associated with greater BCVA improvement. In conclusion, high-frequency SD-OCT follow-up provided a good option for adapting treatment in nAMD individually.

Chronological Registration of OCT and Autofluorescence Findings in CSCR: Two Distinct Patterns in Disease Course

“…It is also worth mentioning that, while some of the aforementioned single components in our pipeline are specialized for their respective modalities, the general layout of our pipeline is applicable for registration between sparse 3D cross-section and en face images as long as a spatial alignment from the cross-sectional scans to some en face modality (e.g., IR [ 16 , 17 ], SLO [ 27 , 28 ], reduced OCT volume [ 19 ]) can be established.…”

“…Previous works have proposed several methods for the registration of FAF and other en face imaging modalities [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Similarly, efforts have been made to visualize OCT labels, e.g., by projecting them onto the accompanying en face infrared (IR) image, where B-scan positions are marked by the OCT device [ 16 , 17 ] or a joint reference space [ 18 ]. In [ 19 ] an en face image is created by reducing the OCT volume.…”

Optical coherence tomography imaging biomarkers associated with neovascular age-related macular degeneration: a systematic review

“…A marked reduction in IRF is observed during the maintenance phase following commencement of anti-VEGF treatment [ 29 , 43 , 44 ]. Whilst some studies report the proportion of eyes with IRF remaining increased over 12 months from 18.2 to 30.6% [ 43 ], others have shown resolution of IRC at month 12 in eyes with IRC at baseline [ 29 ].…”

“…2C ) is in fact associated with superior baseline and outcome BCVA [ 32 , 38 , 47 , 50 , 51 ] and considered a significant predictor of BCVA gains at 12 months, but only when combined with the presence of posterior vitreous detachment [ 52 , 53 ]. However, a recent report has shown a greater range of fluctuation of SRF during 12 months leads to lower BCVA at 12 months whilst a rapid improvement in SRF predicts better BCVA improvement at 12 months [ 44 ].…”

“…The presence of IRF was significantly associated with the presence of HRF in the outer retina, inner retina and SRF layer; the presence of PED was significantly associated with HRF in the inner retina and the presence of SRF was significantly associated with HRF in the SRF layer [ 86 ]. Eyes with more HRF at baseline have shown significantly more reduction in CNV leakage area at month 12 with a rapid reduction in HRF at week 2 associated with lower CRT at month 12 [ 44 ]. HRF quantity is also reportedly significantly correlated with drusen volume at baseline and after 1 year [ 64 , 85 ].…”