Improvements of retinal sensitivity, visual acuity, and central retinal thickness after intravitreal injection of aflibercept in patients with wet age‐related macular degeneration

Abstract

AbstractPurposeTo determine the retinal sensitivity, best‐corrected visual acuity (BCVA), and central retinal thickness (CRT) in patients with wet age‐related macular degeneration (wAMD) after intravitreal aflibercept (IVA).MethodsAn observational study conducted at the Chiba University Hospital between October 2016 and March 2019. All patients were treatment‐naïve with wet AMD and received three monthly (induction phase) and bimonthly (maintenance phase) of IVA for 12 months. Each patient underwent spectral‐domain OCT, fundus autofluorescence, indocyanine green angiography, and microperimetry. The primary outcome was the change in the retinal sensitivity from the baseline at 6 months (6 M). The retinal sensitivity was determined by the average of 13 points within the central 2 degrees and measured by Macular Integrity Assessment (MAIA, CenterVue, Italy). The secondary outcomes were the changes in the BCVA, CRT, presence of subretinal exudations, and greatest linear dimension (GLD) at 12 M relative to the baseline.ResultsThirty‐seven eyes of 37 patients were studied. The mean age was 72.8 ± 7.4 years (mean ± SD), and there were 26 men (72.2%). There were 18 eyes (49%) with typical wAMD and 19 eyes with PCV (51%). The mean retinal sensitivity was significantly improved from 15.4 ± 4.2 dB at the baseline to 19.9 ± 5.0 dB at 3M, 20.3 ± 4.5 dB at 6M, and 20.9 ± 4.6 dB at 12M (all p < 0.0001 relative to baseline). The mean BCVA at the baseline was 0.35 ± 0.23 logMAR units which improved to 0.22 ± 0.28 logMAR units at 12 months (p = 0.001). The BCVA was improved or maintained at 12M in 71% of the patients. The mean CRT and GLD were significantly reduced at 12M (p < 0.001). Twenty‐two eyes (71%) had a dry macula at 12M.ConclusionsThese results indicate that IVA applied with this protocol will improve not only the morphology (CRT) but also the physiology (BCVA, retinal sensitivity) of the retina at 12M.