title: Factors Influencing the Treatment Response of Pigment Epithelium Detachment in Age-Related Macular Degeneration.
abstract: OBJECTIVE
  To study the effect of various baseline factors, particularly the type of drug (ranibizumab vs aflibercept), on the functional and anatomic response of treatment-naïve pigment epithelial detachment (PED) associated with neovascular age-related macular degeneration (neovascular AMD), after 3 intravitreal injections.
  
  
  METHODS
  Retrospective consecutive case series.
  
  
  METHODS
  This study included 102 patients (n = 115 eyes) with treatment-naïve neovascular AMD and PED (>150 μm), who were treated with either ranibizumab (n = 68 eyes) or aflibercept (n = 47 eyes). A multivariate analysis using stepwise linear regression was performed in order to assess factors influencing visual acuity improvement, as well as treatment response of PED height after 3 monthly injections.
  
  
  RESULTS
  Multivariate analysis revealed that better visual improvement was associated with lower best-corrected visual acuity (BCVA) at baseline (P = .001), presence of subretinal fluid (P = .001), and retinal angiomatous proliferation (P = .001); PED reduction was associated with higher PED at baseline (P = .001), predominantly serous PED (P = .003), and the use of aflibercept (P = .022). Drug type was not associated with change in BCVA at 3 months.
  
  
  CONCLUSIONS
  Eyes with neovascular AMD and PED showed significant functional and anatomic response after 3 monthly intravitreal anti-VEGF injections. The functional response depended on baseline BCVA, presence of subretinal fluid, and retinal angiomatous proliferation, while anatomic response was influenced by baseline PED height, degree of vascularization, and drug type. Drug type was not associated with change in BCVA, but had a weak effect on anatomic response.
authors.affiliation: Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland; Jules Gonin Eye Hospital, Fondation Asile des Aveugles (Foundation Asylum for the Blind), Lausanne, Switzerland.
authors.forename: Ali
authors.initials: A
authors.lastname: Dirani
authors.affiliation: Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland; Jules Gonin Eye Hospital, Fondation Asile des Aveugles (Foundation Asylum for the Blind), Lausanne, Switzerland.
authors.forename: Aude
authors.initials: A
authors.lastname: Ambresin
authors.affiliation: Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland; Jules Gonin Eye Hospital, Fondation Asile des Aveugles (Foundation Asylum for the Blind), Lausanne, Switzerland.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Marchionno
authors.affiliation: Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland; Jules Gonin Eye Hospital, Fondation Asile des Aveugles (Foundation Asylum for the Blind), Lausanne, Switzerland.
authors.forename: Doris
authors.initials: D
authors.lastname: Decugis
authors.affiliation: Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland; Jules Gonin Eye Hospital, Fondation Asile des Aveugles (Foundation Asylum for the Blind), Lausanne, Switzerland. Electronic address: irmela.mantel@fa2.ch.
authors.forename: Irmela
authors.initials: I
authors.lastname: Mantel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D000069579:Ranibizumab / Q000627:therapeutic use; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012163:Retinal Detachment / Q000188:drug therapy* / Q000503:physiopathology; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012189:Retrospective Studies; D058471:Subretinal Fluid; 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; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab