Quantitative Subanalysis of Optical Coherence Tomography after treatment with Ranibizumab for Neovascular Age-Related Macular Degeneration
Pearse A Keane 1,
Sandra Liakopoulos 2,
Sharel C Ongchin 1,
Florian M Heussen 1,
Sandeep Msutta 1,
Karen T Chang 1,
Alexander C Walsh 1,
and
SriniVas R. Sadda 1*
1 Ophthalmology, Doheny Retina Institute, Los Angeles, California, United States
2 Ophthalmology, University of Cologne, Cologne, Germany
* To whom correspondence should be addressed. E-mail: sadda{at}usc.edu.
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Abstract |
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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 entitled "OCTOR" which allows precise positioning of pre-specified 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 post-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 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 following initiation of ranibizumab therapy, the effect on the retina was attenuated over time, suggesting a 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.
Key Words:
age-related macular degeneration, optical coherence tomography, angiogenesis
