Retrospective analysis of OCT parameters after intravitreal anti-VEGF inhibitors in neovascular AMD patients in a real-world setting

Abstract

Purpose The aim of the present study was to evaluate changes of best corrected visual acuity (BCVA), retinal nerve fiber layer thickness (RNFL), total macular volume (TMV), intraocular pressure (IOP) and central retinal thickness (CRT) after intravitreal injection of ranibizumab, bevacizumab and aflibercept in patients with neovascular age-related macular degeneration (nAMD) in a clinical real world setting. Methods In a retrospective clinical study design, 120 patients (80 women and 40 men) were analyzed after being diagnosed with nAMD within 8 years (2010–2018). Every patient received at least 6 anti-VEGF injections in a Pro-Re-Nata or Treat-and-Extend regimen. OCT parameters (RNFL, TMV, CRT) and visual acuity (BCVA) were assessed at first diagnosis, at treatment day and during the course. Results Intraretinal fluid was reduced significantly in a magnitude of 88–64 µm (CRT) and 0.75–0.55 mm3 (TMV). Apart from a significant reduction immediately after the therapy start (post-3 injections) with ranibizumab (− 1.4 µm, p = 0.03), RNFL thickness remained constant. A slight improvement in visual acuity of 0.06 logMAR could initially be observed. If further injections were required, only stabilization was achieved compared to baseline visual acuity. Conclusion The changes of OCT parameters CRT, TMV, and RNFL as well as the stabilization of functional results (BCVA) as illustrated in this study comparing effects of different anti-VEGF-agents provide evidence for the transferability of former results to a clinical real-world setting.

Influence of Multiple Anti-VEGF Injections on Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layer Thickness in Patients with Exudative Age-Related Macular Degeneration

“…Luke et al, analyzed OCT parameters (such as total macular volume, RNFL, and central retinal thickness) in 120 eyes treated with multiple intravitreal injections of ranibizumab, bevacizumab, and aflibercept due to neovascular AMD in a clinical real world setting study. They found out that RNFL remained constant over the course of 8 years [ 23 ]. Finally, meta-analysis conducted by Shin et al, found no association between anti-VEGF treatment and RNFL thickness changes in AMD patients [ 24 ].…”