RT Journal Article
SR Electronic
T1 Antidepressant medication and ocular factors in association with the need for anti-VEGF retreatment in neovascular age-related macular degeneration
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 811
OP 815
DO 10.1136/bjophthalmol-2018-312318
VO 103
IS 6
A1 Irmela Mantel
A1 Marta Zola
A1 Olivier Mir
A1 Raphael Gaillard
A1 Francine Behar-Cohen
YR 2019
UL http://bjo.bmj.com/content/103/6/811.abstract
AB Background/Aims Vascular endothelial growth factor (VEGF) is a key player in the pathogenesis of neovascular age-related macular degeneration (nAMD) and is also involved in the final common pathway of antidepressant medication. This study investigated the relationship between the need for anti-VEGF retreatment in patients with nAMD and antidepressant medication, and the potential impact of ocular structural factors.Methods Data from two identical prospective 2-year treatment protocols using ranibizumab or aflibercept in a variable-dosing regimen (‘Observe-and-Plan’) were analysed. Retreatment requirement was compared with antidepressant medication intake (primary outcome) and a variety of ocular factors from baseline and from month 3 response (secondary outcomes), using univariate and multivariate analyses.Results Of the 206 included patients (227 eyes), 19 were on antidepressant medication. Their nAMD eyes significantly more often had pigment epithelium detachment (PED, p=0.04). Multivariate analysis revealed a significant association between anti-VEGF retreatment requirement and antidepressant medication use (p=0.027), as well as thicker central retinal thickness at month 3 (p<0.0001) and month 3 PED height (p=0.001).Conclusion This study provides evidence that treatment with antidepressant medication increases the anti-VEGF retreatment requirement in patients with nAMD, possibly through the interplay of antidepressant medication, depression status and VEGF levels.