Author: Styliani Blazaki (Greece)
Co-authors: Emmanouil Blavakis, Giorgios Smoustopoulos, Georgios Bontzos, Anastasios Stavrakakis, Stamatina Kabanarou, Miltiadis Tsilimbaris
Purpose
To evaluate the progression of macular atrophy (MA) based on infrared (IR) and optical coherence tomography (OCT) images, in patients with age-related macular degeneration (AMD), receiving anti-vascular endothelial growth factor (anti-VEGF) treatment for at least a 6-year period.
Setting/Venue
Retrospective study which conducted in two Retina Departments; Department of Ophthalmology of University Hospital of Heraklion and 31 from the Department of Ophthalmology of Korgialenio-Benakio General Hospital of Athens
Methods
This retrospective study included 53 naïve patients (53 eyes) with neovascular AMD from two centers, who were treated with anti-VEGF intravitreal injections and had no MA at baseline. MA was evaluated in an annual basis using IR and OCT images according to criteria proposed by the Classification of Atrophy Meetings (CAM) group: hyperreflectivity of the choroid, retinal pigment epithelium absence and outer retina atrophy. Incidence and progression of MA were evaluated. Associations with best-corrected visual acuity (BCVA) and total number of injections were also studied.
Results
Treatment duration of our patients was 7.34 ± 1.54 years. The mean number of anti-VEGF injections was 24.4 ± 13.6. BCVA at baseline was 0.38 ± 0.27 logMAR and 0.60 ± 0.35 logMAR at final visit (p=0.731). The cumulative incidence of new MA at years 1, 2, 3, 4, 5, and 6 was 1.89%, 18.87% 32.08%, 39.62%, 49.06% and 50.94% respectively. In patients who developed MA, mean MA area increased from zero at baseline to 5.66±7.18 mm2 at final visit. The estimated annual enlargement of MA was 0.31 mm/year based on square root transformation (1.11 mm2/year, untransformed data). MA progression doesn't appear to be significantly associated with age (R=0.055; p=0.784), gender (R=0.113; p=0.576), BCVA (R=0.168; p=0.404) and total number of injections (R=0.133; p=0.255).
Conlusions
In this real life setting, half of neovascular AMD patients under anti-VEGF treatment, without MA at therapy initiation, developed MA over a period of at least 6 years. In this work, the number of injections did not show a significant association with MA progression.
Financial Disclosure
no conflicts of interest
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