Funktionelle und morphologische mikrostrukturelle Veränderungen in der SD-OCT bei der Langzeitbehandlung der neovaskulären AMD mit Ranibizumab-Monotherapie versus Kombinationstherapie mit PDT

Translated title of the contribution: Functional and Morphological Microstructural Changes in SD-OCT in Long-Term Treatment for Neovascular AMD with Ranibizumab - Monotherapy Versus Combination Therapy with PDT

K. Wand, K. Tetz, I. R. Fischinger, C. P. Lohmann, M. M. Maier, N. Feucht

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Intravitreal anti-VEGF therapy is the gold standard in the treatment of neovascular age-related macular degeneration (nAMD). In recent literature, the benefit of additional photodynamic therapy (PDT) has been debated. The aim of our study was to compare the functional and structural effects of long-term combination therapy with PDT plus ranibizumab with monotherapy with ranibizumab. Material and Methods: In a retrospective study, patients suffering from nAMD were followed up for at least 42 months. Patients were assigned to group A (monotherapy with ranibizumab according to pro re nata [PRN]) or group B (combination therapy with one-time PDT plus ranibizumab according to PRN). The best-corrected visual acuity (BVCA) was evaluated at the starting and end points, together with central retinal thickness (CRT), maximal retinal thickness (MRT) and the maximal diameter of the base of the subretinal plaque in spectral-domain optical coherence tomography (SD-OCT), at the first measurement and at the end point. Results: Group A consisted of 21 eyes (17 patients) and group B consisted of 12 eyes (11 patients). The average follow-up from starting to end point was 64 months and 47 months, from the first measurement of SD-OCT to the end point. Within this period, patients in group A received 19 ± 14 intravitreal injections, and patients in group B received 22 ± 10 intravitreal injections. BCVA at the starting point was 0.31 ± 0.26 in group A and 0.31 ± 0.17 in group B. At the end point, BCVA in group A was 0.29 ± 0.25 (p = 0.405), and in group B 0.25 ± 0.20 (p = 0.142). CRT decreased in group A by 72 ± 178 μm (p = 0.024) and group B by 28 ± 98 (p = 0.1335). MRT decreased in group A by 25 ± 135 μm (p = 0.166) and in group B by 2 ± 118 μm (p = 0.421). The base of the subretinal plaque increased in group A by 32 ± 1468 μm (p = 0.242) and in group B by 748 ± 1024 (p = 0.025). Conclusion: In a long-term follow-up of 5.3 years, patients with nAMD in both groups exhibited good stabilisation of visual acuity. In both groups, retinal thickness decreased and the base of the subretinal plaque increased. With respect to SD-OCT morphological criteria, patients in group A (monotherapy) responded slightly better to therapy than patients in group B (combination group).

Translated title of the contributionFunctional and Morphological Microstructural Changes in SD-OCT in Long-Term Treatment for Neovascular AMD with Ranibizumab - Monotherapy Versus Combination Therapy with PDT
Original languageGerman
Pages (from-to)805-810
Number of pages6
JournalKlinische Monatsblatter fur Augenheilkunde
Volume234
Issue number6
DOIs
StatePublished - 1 Jun 2017
Externally publishedYes

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