Correlation between macular structure and visual outcome following anti-VEGF therapy in wet AMD: a spectral domain optical coherence tomography study

Abstract

Objective To evaluate the macular structure following anti-VEGF therapy in wet AMD patients and to study the correlation of structural findings with visual acuity outcomes, using spectral domain optical coherence tomography (SD-OCT). Methods Thirty-two cases (32 eyes) with wet AMD after anti-VEGF therapy were included in the study.Ophthalmic examination included best-corrected visual acuity (BCVA), dilated fundus examination and OCT imaging 5-6 months after anti-VEGF therapy.Macular thickness and volume were calculated for morphologic parameters of interest including fovea thickness (FT), central subfield thickness (CST), cube volume (CV), cube average thickness (CAT), subretinal fluid (SRF), intraretinal fluid (IRF), CNV membrane thickness (CNVMT) before and after manually identification of fovea.The correlation between BCVA and OCT parameters were investigated.Results Increased CST was correlated with decreased visual acuity (r =0.447, P=0.019), both pre- and post- manually correction.The association was stronger after manually correction if compared with that before correction.No statistically significant association was detected between BCVA and FT, CA and CAT pre- and post-correction.Decreased visual acuity was also correlated with the presence of the IRF and thicker CNV membrane in the macular region.Con- clusions The manually-corrected CST is strongly correlated with BCVA after anti-VEGF therapy in wet AMD patients. Because of the poor visual function and central fixation in these patients due to the complex macular lesions, manually correction of fovea in OCT analysis is definitely necessary in AMD patients. Key words: AMD; Optical coherence tomography; Visual acuity