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Effect of Anti-VEGF Treatment on Choroidal Thickness over Time in Patients with Neovascular Age-related Macular Degeneration

DOI:10.5301/ejo.5000509 期刊:European Journal of Ophthalmology 出版年份:2014 更新时间:2025-09-19 17:15:36
摘要: Purpose: To evaluate change in subfoveal choroidal thickness (SCT) as measured by spectral-domain optical coherence tomography (SD-OCT) in patients with neovascular age-related macular degeneration (NVAMD) undergoing anti–vascular endothelial growth factor (VEGF) therapy. Methods: Patients with a diagnosis of NVAMD were retrospectively reviewed to identify those who had at least 12 months of follow-up. The SCT was manually measured from Bruch membrane to the choroid–sclera junction at baseline and last follow-up. Only cases in which the choroid was fully visible were included in quantitative analyses. The SCT measurements were correlated with other characteristics including number and duration of treatments. Results: Sixty eyes of 47 patients with a follow-up of 23.8 months (SD 7.3) met study inclusion criteria, and 49 eyes of 40 patients received anti-VEGF treatment. Mean age was 83.7 years, and 52% were female. Treated eyes received a mean of 7.8 (SD 7.3) intravitreal anti-VEGF injections. The SCT at baseline was 126.7 μm (SD 50.6) for untreated and 136.2 μm (SD 57.6) for treated eyes. The SCT showed a decrease over time in both groups, with a mean rate of reduction of 6.0 μm (p<0.0002) in treated eyes and 3.6 μm (p = 0.3741) in untreated eyes. However, the change in SCT did not differ between the groups (p = 0.5113), and did not correlate with the number of re-treatments (p = 0.552), visual acuity at baseline (p = 0.618), or change in visual acuity over time (p = 0.429). Conclusions: Although choroidal thickness decreased over time in eyes with NVAMD, anti-VEGF therapy did not appear to accelerate or otherwise alter this decline.
作者: Emma C. McDonnell,Florian M. Heussen,Humberto Ruiz-Garcia,Yanling Ouyang,Ramsudha Narala,Alexander C. Walsh,Srinivas R. Sadda
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To evaluate change in subfoveal choroidal thickness (SCT) as measured by spectral-domain optical coherence tomography (SD-OCT) in patients with neovascular age-related macular degeneration (NVAMD) undergoing anti–vascular endothelial growth factor (VEGF) therapy.

Choroidal thickness decreases over time in eyes with NVAMD, but anti-VEGF therapy does not accelerate or alter this decline. The only significant factor influencing choroidal thickness was patient age.

Retrospective design leading to selection bias, use of multiple SD-OCT instruments, variability in follow-up intervals and injection frequency, assumption of linear reduction in choroidal thickness, potential diurnal variation in choroidal thickness, and limited statistical power due to sample size.

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