title: Improvement of photoreceptor integrity and associated visual outcome in neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate the association between improvement of photoreceptor integrity and visual acuity (VA) after anti-vascular endothelial growth factor (anti-VEGF) injections in neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  Retrospective, cross-sectional study.
  
  
  METHODS
  Eighty-seven eyes of 84 patients who were newly diagnosed with neovascular AMD and treated with anti-VEGF injections were reviewed retrospectively. Using spectral-domain optical coherence tomography, the status of the inner segment/outer segment photoreceptor junction (IS/OS) was graded and classified into 3 groups at baseline and 1 and 2 months after 3 monthly injections. The proportion of the improved IS/OS line after treatment was analyzed and correlated with VA.
  
  
  RESULTS
  The number of eyes in the IS/OS+ group, representing disrupted IS/OS line less than 200 μm, was increased from 9 (10%) at baseline to 33 (38%) at 1 month. There was a significant difference in the ratio of IS/OS+ group between baseline and 1 month (P < .001). Those in the IS/OS± group, showing focal disrupted IS/OS line between 200 and 800 μm, decreased from 29 (33%) to 22 eyes (25%). Improvement of the IS/OS line at 1 month compared to baseline was noted in 43 eyes (49%) and correlated with better VA (P < .016). No increase of VA was observed in 44 eyes without definite improvement. There was no significant correlation between improvement of the IS/OS line and VA from 1 to 2 months.
  
  
  CONCLUSIONS
  Assessing the change of the photoreceptor integrity before and after treatment would be a useful indicator to predict initial response to treatment and visual prognosis in patients with neovascular AMD.
authors.affiliation: The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Min
authors.initials: YM
authors.lastname: Kim
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyoung Jun
authors.initials: HJ
authors.lastname: Koh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000068258:Bevacizumab; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D055211:Retinal Photoreceptor Cell Inner Segment / Q000473:pathology*; D055214:Retinal Photoreceptor Cell Outer Segment / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology*; D057135:Wet Macular Degeneration / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab