Quantitative subanalysis of optical coherence tomography after treatment with ranibizumab for neovascular age-related macular degeneration.
OBJECTIVE
To investigate the effects of ranibizumab on retinal morphology in patients with neovascular age-related macular degeneration (AMD) using optical coherence tomography (OCT) quantitative subanalysis.


METHODS
Data from 95 patients receiving intravitreal ranibizumab for neovascular AMD were collected. StratusOCT images were analyzed using custom software that allows precise positioning of prespecified boundaries on every B-scan. Changes in thickness/volume of the retina, subretinal fluid (SRF), subretinal tissue (SRT), and pigment epithelial detachments (PEDs) at week 1 and at months 1, 3, 6, and 9 after treatment were calculated.


RESULTS
Total retinal volume reached its nadir at month 1, with an average reduction of 0.43 mm(3) (P < 0.001). By month 9, this initial change had been reduced to a mean reduction of 0.32 mm(3) (P = 0.0011). Total SRF volume reached its lowest level by month 1, with an average reduction of 0.24 mm(3) (P < 0.001). This reduction lessened subsequently, to 0.18 mm(3), by month 9. There was an average 0.3-mm(3) decrease in total PED volume by month 1 (P < 0.001), and this later declined further, to 0.45 mm(3), by month 9 (P = 0.0014). Total SRT volume was reduced by an average of 0.07 mm(3) at month 1 (P = 0.0159) and subsequently remained constant.


CONCLUSIONS
Although neurosensory retinal edema and SRF showed an early reduction to nadir after the initiation of ranibizumab therapy, the effect on the retina was attenuated over time, suggesting possible tachyphylaxis. PED volume showed a slower but progressive reduction. Manual quantitative OCT subanalysis may allow a more precise understanding of anatomic outcomes and their correlation with visual acuity.
Keane
Pearse A
PA
Doheny Image Reading Center, Doheny Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California 90033, USA.
Liakopoulos
Sandra
S
Ongchin
Sharel C
SC
Heussen
Florian M
FM
Msutta
Sandeep
S
Chang
Karen T
KT
Walsh
Alexander C
AC
Sadda
Srinivas R
SR
D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001826:Body Fluids / Q000187:drug effects / Q000378:metabolism; D020256:Choroidal Neovascularization / Q000209:etiology*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D010857:Pigment Epithelium of Eye / Q000187:drug effects / Q000473:pathology; D000069579:Ranibizumab; D012160:Retina / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab