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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
DO.02.14 Morphological changes in OCT may be a predictive factor for the efficacy of anti-VEGF treatment in wet AMD Polak K., Bolz M., Ahlers C., Funk M., Georgopoulos M., Schmidt-Erfurth U.
Department of Ophthalmology, Medical University Vienna Objective: Not only the lesion type, but also morphological changes may be a predictive factor for the efficacy of anti-VEGF treatment in macular edema derived from wet AMD. We investigated the predictive value of morphological changes in the retina like the presence of cysts, PED and subretinal fluid (SRF) on retinal function and morphology on anti-VEGF treatment.
Methods: 29 patients presenting with wet AMD (7 eyes with occult CNV, 12 with classic CNV, 5 with minimally classic CNV and 5 RAP-lesions) were included for treatment with intravitreal ranibizumab. Retinal morphologies were assessed with OCT at baseline, 1 and 4 weeks after treatment.
Results: Cystic changes were present in 13 lesions, with large subfoveal cysts in 10 cases. Pigment epithelial detachment was also present in 13 cases, and subretinal fluid in 17 cases. Cystic lesions tended to be reduced 1 week and one month after treatment, this reduction was, however, not significant. Already after one week a significant reduction of the number of lesions with large central cysts was seen (p<0.02). This effect remained constant after one month (p<0.034). The number of lesions with subretinal fluid was also significantly reduced after 1 month (p<0.02). The number of lesions with PED was not significantly changed one month after treatment. In eyes with wet AMD baseline visual acuity was significantly lower (p<0.0007) with the presence of cysts (VA Score 49.3±11.8SD) as compared to eyes without cysts (VA Score 65.5±5.0SD). Visual acuity was not significantly different in patients with or without PED (p=0.8). Taken all lesions together, visual acuity was not significantly changed from baseline one week and one month after treatment. The increase in visual acuity one week and one month after treatment with Ranibizumab was not different in patients who presented with cysts as compared to patients without cysts. Lesions with PED and/or subretinal fluid also had no significantly different change in visual acuity one week and one month after treatment.
Conclusions: Large central cysts and subretinal fluid are significantly reduced one and 4 weeks after treatment with Ranibizumab. This was not paralleled by a change in visual acuity within this short period of time. Morphological changes as seen in OCT are no adequate short-time predictive parameters. Whether cysts, PED or subretinal fluid have predictive value on long-term prognosis, remains to be elucidated.
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