Морфофункциональные исходы при несоблюдении режима антиангиогенной терапии при неоваскулярной форме возрастной макулярной дегенерации у пациентов с низким функциональным статусом

Abstract

Purpose. To study morphological and functional outcomes in patients with neovascular age-related macular degeneration (nAMD) and low visual acuity violating the treatment regimen. Material and methods. Treatment-naive patients as well as patients receiving anti-VEGF therapy with best-corrected visual acuity (BCVA) less than 0.1 were included. Demographic characteristics, changes in BCVA, central retinal thickness (CRT) and structural changes on optical coherence tomography (OCT) were evaluated baseline and at the of the study period. Results. BCVA changed not statistically significantly at the end of the study period in all groups (р > 0.05). A statistically significant decrease of CRT was found only in the group of treatment-naive patients (р = 0.03). Atrophy of the retinal pigment epithelium and subretinal fibrosis were most common among structural changes in advanced nAMD with low visual acuity. These morphological changes persisted by the end of the observation period, without statistically significant changes in the frequency of occurrence. Conclusion. Low visual acuity in patients with advanced nAMD is associated with severe irreversible structural changes in the macula. The use of anti-VEGF therapy in patients with low functional status and severe changes in the macula appears to be unpromising. Keywords: age-related macular degeneration, antiangiogenic therapy, optical coherence tomography, retinal pigment epithelium atrophy, subretinal fibrosis.