gms | German Medical Science

26th Annual Meeting of the German Retina Society

German Retina Society

27.09.2013, Hamburg

Standardized analysis of morphological OCT parameters and correlation with best-corrected visual acuity (BCVA) in antiangiogenic therapy of neovascular age-related macular degeneration (AMD)

Meeting Abstract

  • Christian Simader - Department of Ophthalmology, Medizinische Universität Wien, Austria; Vienna Reading Center, Medizinische Universität Wien, Austria
  • S. Waldstein - Department of Ophthalmology, Medizinische Universität Wien, Austria; Vienna Reading Center, Medizinische Universität Wien, Austria
  • M. Kundi - Institute of Environmental Health, Medizinische Universität Wien, Austria
  • U. Schmidt-Erfurth - Department of Ophthalmology, Medizinische Universität Wien, Austria; Vienna Reading Center, Medizinische Universität Wien, Austria

Retinologische Gesellschaft. 26. Jahrestagung der Retinologischen Gesellschaft. Hamburg, 27.-27.09.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13rg14

doi: 10.3205/13rg14, urn:nbn:de:0183-13rg148

Published: August 20, 2013

© 2013 Simader et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Methods: 1240 patients were treated using ranibizumab/aflibercept in a fixed (year one) and a PRN (year two) regimen in a prospective randomized trial (VIEW2). OCT data were obtained monthly by a standardized protocol and analyzed by an independant reading center.

Results: At baseline, 64% of eyes demonstrated intraretinal cysts (IRC), 80% pigment epithelial detachment (PED) and 84% subretinal fluid (SRF). IRC (p<0.0001) and PED (p=0.028) were associated with a lower initial BCVA. During the loading dose, 75% of SRF, 70% of IRC and 25% of PED resolved under treatment. Functional and morphologic benefit were maintained throughout the fixed regimen. At one year, best visual outcomes with a mean improvement of +12 letters were achieved when only SRF was present at baseline, results were least favourable in IRC+PED with +6 letters only. Switching to a PRN regimen introduced BCVA loss associated with occurrence of novel IRC, while eyes without IRC maintained vision in all groups despite fewer treatments. IRC had a negative impact on final BCVA, with a combination of IRC and PED showing the worst prognosis.

Conclusion: Correlation of OCT and BCVA values revealed a significant negative impact of intraretinal cysts on baseline as well as final BCVA. Occurrence of novel IRC was associated with BCVA loss during the PRN regimen. Intraretinal cystic changes may indicate progression of degenerative disease. Qualitative morphological parameters obtained by OCT correlate with vision outcome and offer adequate guidance for optimal management of antiangiogenic therapy in neovascular AMD.