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Article

Association between Retinal Thickness Variability and Visual Acuity Outcome during Maintenance Therapy Using Intravitreal Anti-Vascular Endothelial Growth Factor Agents for Neovascular Age-Related Macular Degeneration

1
Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Central Ave, Shatin, New Territories, Hong Kong, China
2
2010 Retina & Macula Centre, Tsim Sha Tsui, Kowloon, Hong Kong, China
*
Author to whom correspondence should be addressed.
Academic Editors: Peter D. Westenskow and Andreas Ebneter
J. Pers. Med. 2021, 11(10), 1024; https://doi.org/10.3390/jpm11101024
Received: 25 September 2021 / Revised: 9 October 2021 / Accepted: 11 October 2021 / Published: 14 October 2021
(This article belongs to the Special Issue Age-Related Macular Degeneration and Diabetic Retinopathy)
Previous studies based on clinical trial data have demonstrated that greater fluctuations in retinal thickness during the course of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD) is associated with poorer visual acuity outcomes. However, it was unclear whether similar findings would be observed in real-world clinical settings. This study aimed to evaluate the association between retinal thickness variability and visual outcomes in eyes receiving anti-VEGF therapy for nAMD using pro re nata treatment regimen. A total of 64 eyes which received intravitreal anti-VEGF therapy (bevacizumab, ranibizumab or aflibercept) for the treatment of nAMD were evaluated. Variability in spectral-domain optical coherence tomography (OCT) central subfield thickness (CST) was calculated from the standard deviation (SD) values of all follow-up visits after three loading doses from month 3 to month 24. Eyes were divided into quartiles based on the OCT CST variability values and the mean best-corrected visual acuity values at 2 years were compared. At baseline, the mean ± SD logMAR visual acuity and CST were 0.59 ± 0.39 and 364 ± 113 µm, respectively. A significant correlation was found between CST variability and visual acuity at 2 years (Spearman’s ρ = 0.54, p < 0.0001), indicating that eyes with lower CST variability had better visual acuity at 2 years. Eyes with the least CST variability were associated with the highest mean visual acuity improvement at 2 years (quartile 1: +9.7 letters, quartile 2: +1.1 letters, quartile 3: −2.5 letters, quartile 4: −9.5 letters; p = 0.018). No significant difference in the number of anti-VEGF injections was found between the four CST variability quartile groups (p = 0.21). These findings showed that eyes undergoing anti-VEGF therapy for nAMD with more stable OCT CST variability during the follow-up period were associated with better visual outcomes. Clinicians should consider adopting treatment strategies to reduce CST variability during the treatment course for nAMD. View Full-Text
Keywords: neovascular age-related macular degeneration; anti-VEGF therapy; optical coherence tomography; retinal thickness; visual acuity; variability neovascular age-related macular degeneration; anti-VEGF therapy; optical coherence tomography; retinal thickness; visual acuity; variability
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MDPI and ACS Style

Lai, T.Y.Y.; Lai, R.Y.K. Association between Retinal Thickness Variability and Visual Acuity Outcome during Maintenance Therapy Using Intravitreal Anti-Vascular Endothelial Growth Factor Agents for Neovascular Age-Related Macular Degeneration. J. Pers. Med. 2021, 11, 1024. https://doi.org/10.3390/jpm11101024

AMA Style

Lai TYY, Lai RYK. Association between Retinal Thickness Variability and Visual Acuity Outcome during Maintenance Therapy Using Intravitreal Anti-Vascular Endothelial Growth Factor Agents for Neovascular Age-Related Macular Degeneration. Journal of Personalized Medicine. 2021; 11(10):1024. https://doi.org/10.3390/jpm11101024

Chicago/Turabian Style

Lai, Timothy Y.Y., and Ricky Y.K. Lai 2021. "Association between Retinal Thickness Variability and Visual Acuity Outcome during Maintenance Therapy Using Intravitreal Anti-Vascular Endothelial Growth Factor Agents for Neovascular Age-Related Macular Degeneration" Journal of Personalized Medicine 11, no. 10: 1024. https://doi.org/10.3390/jpm11101024

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