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Originally published In Press as doi:10.1167/iovs.08-1689 on April 11, 2008
 (Investigative Ophthalmology and Visual Science. 2008;49:3115-3120.)
© 2008 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.08-1689
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Quantitative Subanalysis of Optical Coherence Tomography after Treatment with Ranibizumab for Neovascular Age-Related Macular Degeneration

Pearse A. Keane,1 Sandra Liakopoulos,1,2 Sharel C. Ongchin,1 Florian M. Heussen,1 Sandeep Msutta,1 Karen T. Chang,1 Alexander C. Walsh,1 and Srinivas R. Sadda1

1From the Doheny Image Reading Center, Doheny Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California; and the 2Department of Vitreoretinal Surgery, Center of Ophthalmology, University of Cologne, Cologne, Germany.

PURPOSE. To investigate the effects of ranibizumab on retinal morphology in patients with neovascular age-related macular degeneration (AMD) using optical coherence tomography (OCT) quantitative subanalysis.

METHODS. Data from 95 patients receiving intravitreal ranibizumab for neovascular AMD were collected. StratusOCT images were analyzed using custom software that allows precise positioning of prespecified boundaries on every B-scan. Changes in thickness/volume of the retina, subretinal fluid (SRF), subretinal tissue (SRT), and pigment epithelial detachments (PEDs) at week 1 and at months 1, 3, 6, and 9 after treatment were calculated.

RESULTS. Total retinal volume reached its nadir at month 1, with an average reduction of 0.43 mm3 (P < 0.001). By month 9, this initial change had been reduced to a mean reduction of 0.32 mm3 (P = 0.0011). Total SRF volume reached its lowest level by month 1, with an average reduction of 0.24 mm3 (P < 0.001). This reduction lessened subsequently, to 0.18 mm3, by month 9. There was an average 0.3-mm3 decrease in total PED volume by month 1 (P < 0.001), and this later declined further, to 0.45 mm3, by month 9 (P = 0.0014). Total SRT volume was reduced by an average of 0.07 mm3 at month 1 (P = 0.0159) and subsequently remained constant.

CONCLUSIONS. Although neurosensory retinal edema and SRF showed an early reduction to nadir after the initiation of ranibizumab therapy, the effect on the retina was attenuated over time, suggesting possible tachyphylaxis. PED volume showed a slower but progressive reduction. Manual quantitative OCT subanalysis may allow a more precise understanding of anatomic outcomes and their correlation with visual acuity.






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