Spontaneous anatomical improvement on OCT findings in patients with neovascular age‐related macular degeneration without anti‐VEGF treatment

Abstract

PurposeTo present some patients with wet AMD can be improved spontaneously on OCT findings without anti‐VEGF treatment.MethodsWe reviewed the medical records of wet AMD patients visiting Gangneung Asan Hospital from December 2013 to May 2015. There were group of patients who refused to receive anti‐VEGF treatment due to various reasons, even though there were remaining subretinal fluid and/or pigment epithelial detachment on OCT. Among those patients, we investigated spontaneous anatomical improvement cases without anti‐VEGF injection.ResultsThere were nine cases showing spontaneous anatomical improvement on OCT findings. Average age was 70.0 ± 9.4, male was seven, and female was two. Number of anti‐VEGF injection was 4.4 ± 1.7, and injection‐free interval was 12 ± 5.7 months before showing spontaneous anatomical improvement on OCT. Seven cases showed resolution of subretinal fluid, and two cases showed decrease of pigment epithelial detachment size. Initial visual acuity was 0.64 ± 0.36 in LogMAR scale, and final visual acuity improved to 0.40 ± 0.28 in LogMAR scale. Six patients were treated with bevacizumab, two patients received aflibercept, and one patient was injected with ranibizumab. Total follow up periods was 21.0 ± 5.3 months. During the periods, three cases worsened and re‐treatment was performed with anti‐VEGF agents. Six patients have not shown recurrence for more than 6 months. Those nine patients showed relatively small number of anti‐VEGF injection and improvement of visual acuity.ConclusionsThese findings might imply that some patients showing small amount of remaining SRF and/or PED might not need frequent anti‐VEGF injection, especially in patients showing good response to anti‐VEGF therapy with relatively good initial visual acuity. And closed follow up will be essential and needed for those patients.