Abstract
BackgroundTo investigate intravitreal treatment efficiencies in patients suffering from exudative ARMD with a BCVA ≤ 0.05.MethodsRetrospective analysis: Analysis parameters were lesion type, BCVA at baseline and at follow-up, the intravitreal drug used, and its application frequency. Patients were divided into: 1) following injections of bevacizumab, triamcinolone, their combination, or ranibizumab regardless of their lesion subtype, 2) or by lesion subtype. Statistical tests were performed using Wilcoxon signed-rank tests, Kruskal-Wallis tests and multivariable logistic regressions.ResultsSeventy four eyes of 74 patients were analyzed. Follow-up was at 12.0 to 15.7 weeks. Median difference of BCVA (logMAR) between baseline and follow-up was 0.000 (−0.030, 0.175) in classic (p = 0.105), 0.000 (−1.15, 0.20) in occult (p = 0.005), −0.200 (−1.20, 0.60) in cases with subretinal fluid (p = 0.207), 0.000 (-0.60, 0.30) in pigment epithelial detachment (p = 0.813), and 0.050 (−0.40, 0.70) in Junius Kuhnt maculopathy (p = 0.344). BCVA increased ≥ 0.2 logMAR in 4 (24 %) classic, 9 (47 %) occult, 6 (33 %) pigment epithelial detachment, 6 (55 %) subretinal fluid, in 29 (39 %) eyes regardless of the lesion type, and reached a BCVA ≥ 0.05 in 7 (9 %) of those with a baseline BCVA <0.05.ConclusionsResults indicate that in patients with ARMD and a BCVA lower 0.05, intravitreal treatment may improve visual acuity, most probably in cases with occult lesions.
Highlights
To investigate intravitreal treatment efficiencies in patients suffering from exudative Age-related macular degeneration (ARMD) with a best corrected visual acuity (BCVA) ≤ 0.05
The primary aim of our analysis was to investigate whether intravitreal treatment in exudative ARMD and BCVA ≤ 0.05 had improved visual acuity in our patients
1. regardless of the subtype of choroidal neovascular membrane (CNV), 2. according to the subtype of CNV, 3. patients without possible CNV classification presenting subretinal fluids, 4. patients without possible CNV classification presenting pigment epithelial detachment, 5. patients without CNV classification presenting macular scars and hemorrhages, defined as Junius-Kuhnt maculopathy. This is a retrospective analysis of patients suffering from exudative ARMD with BCVA ≤ 0.05 at baseline, who received intravitreal injections of bevacizumab, ranibizumab, triamcinolone, or in combination at our University hospital
Summary
To investigate intravitreal treatment efficiencies in patients suffering from exudative ARMD with a BCVA ≤ 0.05. Age-related macular degeneration (ARMD) has become one of the most threatening ophthalmologic diseases in patients older than 50 years from developed countries such as the United States or central Europe [1]. A few years ago, insurance companies requested a minimal best corrected visual acuity of ≥ 0.05 to financially cover ARMD. The primary aim of our analysis was to investigate whether intravitreal treatment in exudative ARMD and BCVA ≤ 0.05 had improved visual acuity in our patients. Patients without possible CNV classification presenting subretinal fluids, 4. Patients without possible CNV classification presenting pigment epithelial detachment, 5. Patients without CNV classification presenting macular scars and hemorrhages, defined as Junius-Kuhnt maculopathy Koch et al BMC Ophthalmology (2015) 15:138 lower than 0.05, probably because such inclusion criterias, a minimal BCVA of 0.05 or 0.0625, have been comparatively adapted since the beginning of photodynamic treatment with verteporfin in 2003 in all major studies, e.g. TAP, VIP, FOCUS, ANCHOR, MARINA, PIER, or IVAN [10,11,12,13,14,15,16].
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