THE INFLUENCE OF VITREOMACULAR ADHESION ON OUTCOMES AFTER AFLIBERCEPT THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.
OBJECTIVE
To evaluate the influence of vitreomacular attachment on outcomes after intravitreal aflibercept for neovascular age-related macular degeneration.


METHODS
In a prospective case series, eyes with neovascular age-related macular degeneration were treated with intravitreal aflibercept, given as 3 consecutive monthly injections, followed by further injection every 2 months. Spectral domain optical coherence tomography images were reviewed at each visit to determine the attachment of the posterior hyaloid. Best-corrected visual acuity and retinal thickness were also recorded. Outcomes at Months 2 and 6 were compared between the eyes with persistent vitreomacular attachment (Stage 1) and those with posterior vitreous detachment (Stages 2 or 3 PVD) at baseline.


RESULTS
At baseline, 30 eyes had Stage 1 PVD and 63 eyes had either Stage 2 or 3 PVD. Although there was a trend for both greater visual acuity gains and reductions in retinal thickness for the eyes with Stages 2 or 3 PVD, this failed to reach significance. Baseline visual acuity and age were negatively associated with visual acuity change, and baseline retinal thickness alone was associated with retinal thickness change.


CONCLUSIONS
Visual acuity, retinal thickness, and age at the baseline examination, but not PVD status, are associated with functional and anatomical outcomes after intravitreal aflibercept for neovascular age-related macular degeneration.
*Eye Clinic, St James's University Hospital, Leeds, United Kingdom; †Birmingham Midlands Eye Centre, City Hospital, Birmingham, United Kingdom; and ‡Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom.
Martin A
MA
McKibbin
Carlo A
CA
Suter
Thomas A
TA
Willis
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D011446:Prospective Studies; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012160:Retina / Q000473:pathology; D012164:Retinal Diseases / Q000503:physiopathology*; D000267:Tissue Adhesions / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology*; D014822:Vitreous Body / Q000502:physiology; D020255:Vitreous Detachment / Q000503:physiopathology*; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology
D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor