Long-term changes in retinal layers in patients undergoing intravitreal ranibizumab for neovascular age-related macular degeneration

Impact of intravitreal ranibizumab, aflibercept and bevacizumab on retinal ganglion cell and nerve fibre layer thickness in Neovascular age‐related macular degeneration

“…However, their methods and results were inconsistent. Makri et al (2017) ( N = 65) and Inan et al (2019) ( N = 33) studied patients on intravitreal ranibizumab therapy over a 1 year period. While Inan et al and our study showed a significant reduction in RGCL thickness under intravitreal therapy with ranibizumab, the change in RGCL thickness in the Makri study was not significant, likely because they included only lesion‐free areas and, therefore, did not detect the therapeutic reduction in fluids under intravitreal anti‐VEGF.…”

“…Their findings were also inconsistent. Makri et al (2017), Inan et al (2019), Demirel et al (2015) ( N = 29), Sengul et al (2016) ( N = 168), Martinez‐de‐la‐Casa et al (2012) ( N = 49) and Valverde‐Megías et al (2019) ( N = 20) studied ranibizumab. Only Martinez‐de‐la‐Casa et al and Valverde‐Megías et al found a significant reduction in RNFL after a follow‐up period of 1 and 8 years, respectively.…”

“…Therefore, chronic suppression of VEGF could reduce the survival of RGCs and result in a deleterious downstream effect on retinal nerve fibres layer (RNFL) (Horsley et al, 2010). Indeed, several studies found a significant reduction in RGC Layer (RGCL) thickness after treatment with intravitreal anti‐VEGFs (Abdolrahimzadeh et al, 2019; Aşikgarip et al, 2021; Beck et al, 2016; Inan et al, 2019; Lee, Sim, et al, 2020).…”

The Impact of Intravitreal Ranibizumab Treatment on Outer Retinal Layer Thickness in Neovascular Age-related Macular Degeneration

“…OCT-segmentation studies enable to report thickness changes in inner retinal layers associated with the treatment of neovascular AMD with ranibizumab (14,15,16,17). Moreover, in an OCT segmentation study that investigated the impact of aging on the outer retinal layer and choroid, it was shown that the RPE and photoreceptor layers and the choroidal thickness decreased with increasing age (26).…”

“…Non-etheless, VEGF is a mediator with vital importance for retinal photoreceptors, Müller cells, and RPE as well as for the integrity of choriocapillaris (12,13). Inner retinal layers with a peripapillary nerve and retinal ganglion cell layer rather than outer retinal layer have become more extensively addressed by the segmentation studies in AMD patients with limited data on SD-OCT-based automatic segmentation analysis of outer retinal layer in relation to visual function in neovascular AMD patients (8,14,15,16,17). Hence, whether the VEGF suppression has potential age independent hazards on the outer retina remains an enigma.…”