title: Foveal structure during the induction phase of anti-vascular endothelial growth factor therapy for occult choroidal neovascularization in age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate the efficacy of monthly injections of aflibercept and ranibizumab on foveal structure after three months, for the treatment of occult choroidal neovascularization (CNV) in age-related macular degeneration (AMD).
  
  
  METHODS
  We retrospectively studied 103 eyes with treatment-naïve neovascular AMD with occult and no classic CNV. Seventy-four of 103 eyes were treated with ranibizumab (intravitreal ranibizumab injection [IVR] group); 29 eyes were treated with aflibercept (intravitreal aflibercept injection [IAI] group). The best-corrected visual acuity and the retinal and choroidal structure at the fovea were evaluated using optical coherence tomography.
  
  
  RESULTS
  The total foveal thickness, the height of serous retinal detachments, and subfoveal choroidal thickness were compared with baseline, and the incidence of retinal pigment epithelial elevation significantly decreased in the IAI group compared with the IVR group. In contrast, the thickness of the sensory retina at the fovea significantly decreased in the IVR group when compared with the IAI group. The logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity improved more significantly in the IVR group (-0.085±0.164) than in the IAI group (-0.020±0.125) at 3 months (P=0.017).
  
  
  CONCLUSIONS
  After intravitreal injection, aflibercept more rapidly reduced subretinal fluid and subfoveal choroidal thickness. In contrast, ranibizumab decreased the sensory retinal thickness compared with aflibercept. The responses of the retinal and choroidal tissue to these anti-VEGF agents may be different during the induction phase for eyes with occult CNV secondary to neovascular AMD.
authors.affiliation: Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Kano
authors.affiliation: Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima, Japan.
authors.forename: Tetsuju
authors.initials: T
authors.lastname: Sekiryu
authors.affiliation: Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima, Japan.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Sugano
authors.affiliation: Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Oguchi
authors.affiliation: Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ojima
authors.affiliation: Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Itagaki
authors.affiliation: Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Saito
keywords: aflibercept; neovascular age-related macular degeneration; occult; outer nuclear layer; ranibizumab; retinal thickness