Abstract
Purpose. To evaluate the ability of spectral-domain optical coherence tomography to detect subtle amounts of retinal fluid when the choroidal neovascularization is detected as inactive via time-domain optical coherence tomography and clinical examination in neovascular age-related macular degeneration (nAMD) patients. Methods. Forty-nine eyes of 49 patients with nAMD after ranibizumab treatment were included in this cross-sectional, prospective study. All patients were imaged with TD-OCT and SD-OCT at the same visit one month after a ranibizumab injection. The presence of subretinal, intraretinal, and subretinal pigment epithelium fluid (subRPE) in SD-OCT was evaluated; also mean central retinal thickness (CRT) and the rate of vitreoretinal surface disorders detected via the two devices were evaluated. Results. The mean CRT via TD-OCT and SD-OCT was 218.1 ± 51.3 and 325.7 ± 78.8 microns. Sixteen patients (32.6%) showed any kind of retinal fluid via SD-OCT. In detail, 8 patients (16.3%) showed subretinal fluid, 10 patients (20.4%) showed intraretinal fluid, and 3 patients (6.1%) showed SubRPE fluid. The ability of detecting vitreoretinal surface disorders was comparable between the two devices, except vitreomacular traction. Conclusion. SD-OCT is essential for the nAMD patients who are on an as-needed treatment regimen with ranibizumab. Only TD-OCT and clinical examination may cause insufficient treatment in this group of patients.
Highlights
Neovascular age-related macular degeneration is the leading cause of visual loss among the elderly population in developed countries [1, 2]
Studies like PRONTO and FUSION were designed to evaluate the effectiveness of as-needed treatment regimens, and ranibizumab was found to be effective in the treatment of Neovascular age-related macular degeneration (nAMD) on as-needed treatment regimens [11, 14]
We aimed to evaluate the activity of choroidal neovascularization with SD-Optical coherence tomography (OCT) in the nAMD patients who were on an as-needed treatment regimen with ranibizumab and were diagnosed to have an inactive choroidal neovascularization with TD-OCT and clinical examination one month after intravitreal ranibizumab injection
Summary
Neovascular age-related macular degeneration (nAMD) is the leading cause of visual loss among the elderly population in developed countries [1, 2]. Before the introduction of intravitreal antivascular endothelial growth factor therapy for nAMD, only prevention for visual loss might have been achieved in a limited number of patients with different treatment options like laser photocoagulation and photodynamic therapy [3,4,5,6,7]. The pivotal multicenter studies with ranibizumab, like MARINA, ANCHOR, PRONTO, EXCITE, and CATT, showed that ranibizumab is effective to prevent baseline visual acuity in up to 95% of the patients and is effective to make an improvement in visual acuity in up to 40% of the patients [9,10,11,12,13]. CATT study was designed to compare the outcomes of monthly and as-needed treatment regimens for both bevacizumab and ranibizumab [13].
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