Author: Selim Cevher (Turkey)
Co-authors: Çağatay Çağlar
The current treatment modalities of Neovascular Type Age-Related Macular Degeneration base on anti-vascular endothelial growth inhibitor agents. Bevacizumab is one of these agents. These agents are given into the vitreous space through the pars plana. Ciliary muscles may be affected by both trauma during injection and may be affected by the effect of anti-vascular endothelial growth inhibitor agent. In the current study, we aimed to investigate the effect of intravitreal bevacizumab on ciliary muscle thickness in Neovascular Type Age-Related Macular Degeneration using ultrasonic biomicroscopy.
Hitit University Medicine Faculty of Medicine, Department of Ophthalmology, Turkey
This study conducted in the Department of Ophthalmology. 15 eyes of 15 patients who were diagnosed with Neovascular Type Age-Related Macular Degeneration, who had not received any treatment before, and who received 3 doses of intravitreal bevacizumab were taken. Before bevacizumab treatment, patients underwent complete ophthalmological examination, optical coherence tomography, ultrasonic biomicroscopy, and fundus fluorescein angiography. All patients received 3 doses of bevacizumab injections one month apart. Ciliary muscle thickness measurements were performed using ultrasonic biomicroscopy before the treatment and one month after the 3rd dose bevacizumab treatment. The best-corrected visual acuities (BCVA), central macular thickness (CMT), and temporal ciliary muscle thickness were compared before and after the treatment in the 4th month.
Fifteen patients, 8 males (53.3%) and 7 females (46.7%), with a mean age of 72.2 years, participated in the study. While the pre-treatment BCVA was 1.09 ± 0.62logMAR, it was 0.63 ± 0.06logMAR at the 4th month (p: 0.008). The mean pre-treatment CMT value was 367.53 ± 48.02 μm, while the mean CMT value at the 4th month was 308.87 ± 71.49 μm (p 0.001). Ciliary muscle thicknesses 1mm (M1), 2mm (M2) and 3mm (M3) from the scleral spur before treatment and at the 4th month, respectively 1.02mm and 0.90mm (p: 0.002) for M1, 0.69mm for M2 It was 0.61mm (p: 0.003), 0.41 and 0.36mm (p 0.001) for M3 (Figure 1 and Figure 2). No complications were observed in any of the cases.
This study is an important study investigating the effect of bevacizumab treatment on ciliary muscle thickness, and a significant decrease in ciliary muscle thickness measurements was found in the study. Changes in ciliary muscle anatomy after bevacizumab treatment may cause impairment in the accommodation mechanism. In addition, the ciliary body is likely to be affected and may cause deterioration of the aqueous humor production.