Choroidal thickness in exudative age‐related macular degeneration and influence of intravitreal anti‐VEGF treatment

Abstract

Purpose: To evaluate choroidal thickness progression over time in patients with exudative age‐related macular degeneration (AMD) and its relation with anti‐VEGF treatment. Methods: Retrospective observational case series. Study group included patients observed between January 2022 and April 2022 at Ophthalmology Department of Hospital de São João, Porto, Portugal, diagnosed with bilateral exudative AMD (eAMD) or unilateral eAMD and intermediate AMD (iAMD) in contralateral eye with a minimum follow up of 2 years. Subfoveal choroidal thickness was measured in each of the studied eyes using cross‐sectional spectral domain optical coherence tomography images, obtained every year during follow‐up period. Statistical analysis was performed to correlate choroidal thickness variation with number of intravitreal injections. Results: 66 eyes with eAMD and 20 eyes with iAMD from 43 patients (mean age, 81.15 ± 6.10 years) followed during 7.15 ± 2.65 years. eAMD eyes were treated with 54.83 (range 6–100 injections) anti‐VEGF intravitreal injections. Choroidal thickness of eyes with eAMD decreased 56.65 ± 11.66 μm over the follow up period (p < 0.001) at a rate of 6.49 μm per year. Choroidal thickness of eyes with iAMD decreased 29.30 ± 22.07 μm over the follow up period (p > 0.2) at a slower rate of 0.68 μm per year. In the subgroup of patients with unilateral eAMD and contralateral iAMD (n = 20), choroidal thickness changes were significantly different between the two eyes (p < 0.001). Number of intravitreal injections correlated inversely with choroidal thickness in eyes with eAMD (r = −0.232; p < 0.001). Conclusions: A significant thinning of choroid in eyes with eAMD and an inverse correlation with number of anti‐VEGF injections was observed, suggesting the influence of prolonged anti‐VEGF suppression on choroidal thickness decrease. Further studies with a higher number of eyes are needed to validate our results.