Association between choroidal thickness and the response to intravitreal ranibizumab injection in age‐related macular degeneration

Abstract

ABSTRACT.Purpose: To investigate the relationship between the choroidal thicknesses of eyes of patients with age-related macular degeneration (AMD) and the outcomes of intravitreal ranibizumab injection. Methods: We reviewed the medical records of 141 consecutive eyes (80 with typical neovascular AMD and 61 with polypoidal choroidal vasculopathy [PCV]) treated by intravitreal ranibizumab and 121 normal control eyes matched in terms of age and spherical equivalent (SE). Eyes of patients were divided into three subgroups with thin, medium and thick choroids. We investigated the relationships between choroidal thickness and treatment outcomes of intravitreal ranibizumab. Results: In eyes with typical neovascular AMD, thin choroids were associated with older age (linear regression; p < 0.0001) and larger choroidal neovascularization (CNV) lesions (p = 0.049). Patients with thin choroids had a higher prevalence of intra-/subretinal fluid (generalized estimated equation; thin versus medium p < 0.0001; thin versus thick p = 0.003), and less visual gain from baseline to 12 months after treatment, than did other subgroups (linear mixed model; thin versus medium p < 0.0001; thin versus thick p = 0.023). PCV eyes with thick choroids more often had retinal fluid, and eyes with thin choroids experienced more frequent resolution of retinal fluid, from baseline to 12 months after treatment (thick versus medium p < 0.0001, thick versus thin p < 0.0001, thin versus medium p = 0.001). No intergroup difference in post-treatment functional outcome was noted in eyes with PCV (p = 0.584). Conclusions: Subfoveal choroidal thickness was associated with functional and anatomical outcomes after intravitreal ranibizumab injection in eyes with typical neovascular AMD and PCV.

Stereotactic radiotherapy in neovascular age-related macular degeneration

“…[38] Decreased vessel density and/or tissue shrinkage has been suggested. Interestingly, Shin et al [39] postulated the thinner the choroid the higher the prevalence of intra/subretinal fluid. Opposite to this, Razavi et al [40] associated a thicker choroid to hyperpermeability and enhanced exudation.…”

Low-Energy Stereotactic Radiotherapy for Treatment of Exudative Age-Related Macular Degeneration in a Treat-and-Extend Regimen

“…Furthermore, it is not known if a further choroidal thinning may even worsen the visual capacity of the patients. 28,29 Regarding long term efficacy, a too-intensive SRT might even decrease the VA by causing a strong fibrotic layer, decreasing the nutritional retinal support, or further atrophy of retinal or choroidal layers. These effects need to be evaluated in long term follow-ups, in addition to other options like a further reduction of radiation dose (ie, to 12 Gy) or an earlier indication with a very focused SRT to a reduced volume might be investigated.…”

Gender variation in central serous chorioretinopathy

“…Interestingly, there has been a reported higher risk of neovascular AMD in women in a meta-analysis in European populations [2]. Conversely, no gender differences were shown in the prevalence of retinal vein occlusion in a recent cross-sectional observational study [3].…”