Korean J Ophthalmol.  2014 Dec;28(6):466-472. 10.3341/kjo.2014.28.6.466.

Intravitreal Anti-vascular Endothelial Growth Factor for Typical Exudative Age-related Macular Degeneration in Eyes with Good Baseline Visual Acuity

• Chang YS
• Han JI
• Yoo SJ
• Lew YJ
• Kim JH

• KMID: 2345823
• DOI: http://doi.org/10.3341/kjo.2014.28.6.466

Abstract

PURPOSE
To investigate 12-month treatment outcomes of anti-vascular endothelial growth factor therapy in eyes with typical exudative age-related macular degeneration with good baseline visual acuity.
METHODS
This retrospective observational case series included 18 eyes (18 patients) with typical exudative age-related macular degeneration with a baseline best-corrected visual acuity of 20 / 25 or better. Patients were treated with anti-vascular endothelial growth factor monotherapy during the 12-month follow-up period. Baseline visual acuity and central foveal thickness were compared to the values at 12 months.
RESULTS
Patients received an average of 4.4 +/- 1.3 intravitreal anti-vascular endothelial growth factor injections. The mean logarithm of minimum angle of resolution visual acuity was 0.08 +/- 0.04, 0.08 +/- 0.07, 0.12 +/- 0.09, and 0.16 +/- 0.11 at baseline, three months, six months, and 12 months, respectively. Visual acuity at 12 months was significantly worse than the baseline value at diagnosis (p = 0.017), and the mean central foveal thickness at the defined time points was 270.2 +/- 55.6, 204.4 +/- 25.4, 230.1 +/- 56.3, and 216.8 +/- 48.7 microm, respectively. The central foveal thickness at 12 months was significantly less than the baseline value at diagnosis (p = 0.042).
CONCLUSIONS
Deterioration in visual acuity was noted in eyes with typical exudative age-related macular degeneration with good baseline visual acuity, suggesting the need for close patient monitoring and prompt treatment even in patients with good baseline visual acuity.

Keyword

Anti-vascular endothelial growth factor; Bevacizumab; Good visual acuity; Macular degeneration; Ranibizumab

MeSH Terms

Aged
Angiogenesis Inhibitors/*therapeutic use
Bevacizumab/therapeutic use
Choroidal Neovascularization/*drug therapy/physiopathology
Female
Fluorescein Angiography
Humans
Intravitreal Injections
Male
Middle Aged
Ranibizumab/therapeutic use
Retrospective Studies
Tomography, Optical Coherence
Vascular Endothelial Growth Factor A/antagonists & inhibitors
Visual Acuity/*physiology
Wet Macular Degeneration/*drug therapy/physiopathology
Angiogenesis Inhibitors
Bevacizumab
Ranibizumab
Vascular Endothelial Growth Factor A

Figure

• 

  Fig. 1 Changes in mean logarithm of minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA, A) and central foveal thickness (B) in eyes diagnosed with typical exudative age-related macular degeneration with good baseline visual acuity. Statistical analyses were performed using repeated measures analysis of variances with Bonferroni's correction.

• 

  Fig. 2 Fluorescein angiography (A) and optical coherence tomography (B,C,D) findings in an eye with typical exudative age-related macular degeneration. The best-corrected visual acuity at the time of diagnosis was 20 / 25 (A,B). The eye received six ranibizumab injections during the 12-month follow-up period, but the subretinal lesion enlarged, as seen on optical coherence tomography at six (C) and 12 (D) months. A decrease in visual acuity to 20 / 50 was observed at 12 months.

• 

  Fig. 3 Fluorescein angiography (A) and optical coherence tomography (B,C,D) findings of an eye diagnosed with typical exudative age-related macular degeneration. The best-corrected visual acuity at the time of diagnosis was 20 / 25 (A,B). After three consecutive ranibizumab injections, exudation recurrence was not noted during the 12-month follow-up period, as verified by optical coherence tomography at six (C) and 12 (D) months. The best-corrected visual acuity at 12 months was maintained at 20 / 25.

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