[Specific alterations in the retinal microstructure in neovascular age-related macular degeneration under anti-VEGF therapy. A detailed analysis of intraretinal changes and their possible role for follow-up].
BACKGROUND
High-definition raster scanning spectral-domain optical coherence tomography (SD-OCT) allows a precise assessment of retinal layers and a more detailed detection of subtle morphological alterations. The aim of this study was to observe such changes in patients with neovascular age-related macular degeneration (nAMD) under anti-VEGF therapy and to evaluate if they show characteristic and reversible properties.


METHODS
The study included 20 consecutive patients with untreated nAMD. SD-OCT with an axial resolution of 6 µm and a scan velocity of up to 25,000 A-scans/s was used for high-resolution imaging of the macular region at baseline and at months 1 and 3. Characteristic changes in the retinal microstructure were documented and analyzed.


RESULTS
Obvious morphological changes as well as discrete intraretinal alterations showed a clear improvement until the third month following the initial ranibizumab injection. Destructions of the neurosensory retina and the outer retinal layers were partly reversible and significantly reduced after treatment was applied.


CONCLUSIONS
SD-OCT was able to detect additional information on specific morphological alterations within the retina. These changes showed a considerable reduction under consistent treatment indicating their potential value for monitoring treatment success in antiangiogenic strategies.
Universitätsklinik für Augenheilkunde und Optometrie, Medizinische Universität Wien, Wien, Österreich.
T
T
Schneiderbauer
C
C
Ahlers
G
G
Stock
I
I
Golbaz
C
C
Schütze
S
S
Sacu
U
U
Schmidt-Erfurth
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012160:Retina / Q000187:drug effects / Q000473:pathology*; D015861:Retinal Neovascularization / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D042262:Retinoscopy / Q000379:methods; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab