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Morphological characteristics of eyes with neovascular age-related macular degeneration and good long-term visual outcomes after anti-VEGF therapy
  1. Mengyuan Fang1,2,
  2. Karntida Chanwimol2,
  3. Jyotsna Maram2,
  4. Ghazala A Datoo O'Keefe3,
  5. Charles C Wykoff4,5,
  6. David Sarraf6,
  7. A’sha Brown3,
  8. Shaun Ian Retief Lampen4,5,
  9. Brenda Zhou4,5,
  10. Alexander M Rusakevich4,5,
  11. SriniVas Sadda2,6
  1. 1Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
  2. 2Doheny Eye Institute, Doheny Image Reading Center, Los Angeles, California, USA
  3. 3Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA
  4. 4Retina Consultants of Houston, Houston, Texas, USA
  5. 5Blanton Eye Institute, Houston Methodist Hospital & Weill Cornell Medical College, Houston, Texas, USA
  6. 6Department of Ophthalmology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA
  1. Correspondence to Dr SriniVas Sadda, Doheny Eye Institute Doheny Image Reading Center, Los Angeles, California, USA; ssadda{at}doheny.org

Abstract

Purpose To analyse the morphological characteristics of eyes with neovascular age-related macular degeneration (AMD) with good long-term visual acuity after anti-VEGF (vascular endothelial growth factor) therapy.

Methods Retrospective, observational study of 175 patients with neovascular AMD with >5 years of follow-up after initiating anti-VEGF therapy. Spectral-domain optical coherence tomography images were assessed for thickness of pigment epithelial detachment (PED), subretinal hyper-reflective material (SHRM), subretinal fluid and subfoveal choroidal, as well as the integrity of the outer retinal bands.

Results The final analysis cohort included 203 eyes (175 patients) followed for a mean of 7.84±1.70 years (range: 5–11). The maximum PED thickness in the foveal central subfield (FCS) was significantly lower (p<0.001) in the poor vision group (13.11 μm) compared with the intermediate (86.25 μm) or good (97.92 μm) vision groups, respectively. In contrast, the maximum thickness of SHRM in the FCS was significantly thicker (p<0.001) in eyes with poor vision (149.46 μm) compared with eyes with intermediate vision (64.37 μm) which in turn were significantly thicker (p<0.001) than eyes with good vision (9.35 μm). The good vision group also had better continuity of all outer retinal bands (external limiting membrane, ellipsoid zone, and retinal pigment epithelium) compared with the other two groups (all p<0.001).

Conclusion A thicker PED and thinner SHRM were correlated with better vision in eyes with neovascular AMD following long-term anti-VEGF therapy. If replicated in future prospective studies, these findings may have implications for design of optimal anatomic endpoints for neovascular AMD treatment.

  • imaging
  • retina
  • treatment other

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. There is no additional information available.

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Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. There is no additional information available.

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Footnotes

  • Contributors MF and SS had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: MF and SS. Acquisition, analysis or interpretation of data: All authors. Drafting of the manuscript: MF and SS. Critical revision of the manuscript for important intellectual content: MF, GDO’K, CW, DS and SS. Statistical analysis: MF, KC and JM. Administrative, technical or material support: GDO’K, CW, DS, AB, SIRL, BZ, AMR and SS. Study supervision: GDO’K, CW, DS and SS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. CW reported receiving grants, personal fees or nonfinancial support from Adverum, Aerie Pharmaceuticals, Aldeyra, Alimera Sciences, Allergan, Apellis, Arctic Vision, Arrowhead, Bausch + Lomb, Bayer, Bionic Vision Technologies, Boehringer Ingelheim, Chengdu Kanghong Biotechnologies (KHB), Clearside Biomedical, EyePoint, Gemini Therapeutics, Genentech, Graybug Vision, Gyroscope, IONIS Pharmaceutical, IVERIC Bio, Kato DSRC, Kodiak Sciences, LMRI, Neurotech Pharmaceuticals, NGM Biopharmaceuticals, Novartis, OccuRx, Ocular Therapeutix, ONL Therapeutics, Opthea, Outlook Therapeutics, Oxurion (formerly Thrombogenics), Palatin, Pentavision, PolyPhotonix, RecensMedical, Regeneron, RegenXBio, Roche, SAI MedPartners, SamChunDang Pharm., Santen, Senju, Taiwan Liposome Company, Takeda, Thea Open Innovation, Verana Health, Visgenx, Xbrane BioPharma. DS reported receiving grants, personal fees, or nonfinancial support from Amgen, Genentech, Heidelberg, Optovue, Regeneron, Topcon, Bayer, Iveric Bio, Novartis. SS reported receiving grants, personal fees, or nonfinancial support from Carl Zeiss Meditec, Nidek, Topcon, Heidelberg, Optos, Centervue, Amgen, Allergan, Genentech/Roche, Oxurion, Novartis, Regeneron, Bayer, 4DMT, Merck, Apellis, Astellas.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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