Session Title: Free Paper Session 14: AMD IV
Session Date/Time: Friday 08/09/2017 | 16:30-18:00
Paper Time: 16:48
Venue: Room 111
First Author: : A.Suzumura JAPAN
Co Author(s): : K. Takayama H. Kaneko H. Terasaki
To evaluate whether intravitreal anti-vascular endothelial growth factor therapy is effective against age-related macular degeneration with asteroid hyalosis
We retrospectively reviewed consecutive 10 eyes (male 6 eyes, female 4 eyes, all Japanese) of naïve wet AMD with AH during the follow-up period at the Nagoya University Hospital from December 2012 through July 2015.
The clinical diagnosis of wet AMD and diagnosis of subtypes were based on fundoscopic examinations, optical coherence tomography (OCT) examination, fluorescence angiography (FA), and indocyanine green angiography (ICGA). The existence of intraretinal/subretinal fluid was confirmed by OCT and the greatest linear dimension (GLD) was measured from the image obtained by ICGA at late phase. A 0.12-mL aliquot of aflibercept (40 mg/mL) or 0.165-mL aliquot of ranibizumab (10 mg/mL) were injected. The best-corrected visual acuity (BCVA) was measured before intravitreal anti-VEGF injection and one month after each injection. A standard Japanese decimal visual acuity chart was used, and BCVA values were converted to the Early Treatment Diabetic Retinopathy Study (ETDRS) letters. We measured central retinal thickness (CRT) and central choroidal thickness (CCT) with OCT at baseline and one month after each injection. CRT was measured from the upper fovea to Bruch’s membrane, and CCT was measured from the lower RPE line to choroidal-scleral interface by using the caliper function of the machine. Mann–Whitney U test was used to compare these data. Multiple linear regression analysis was performed between BCVA, CRT, CCT, fluid remind and GLD, IVR / IVA, subtypes of AMD. (P) value less than 0.05 was considered statistically significant.
The mean age of the patients was 77.4 ± 3.4 years old (ranged from 72 years old to 84 years old). Classified with subtypes of AMD, six eyes had typical AMD and four eyes had polypoidal choroidal vasculopathy. Mean VA, CRT and CCT were 68 ± 6.8 letters, 264 ± 96 µm, 281 ± 109 µm at baseline, and 69.5 ± 6.4 letters, 192 ± 36 µm, 271 ± 120 µm after third injection, respectively. No significant changes in VA, CRT, and CCT from the baseline to after third injection (P = 0.35, 0.051 and 0.50,respectively). Six eyes were treated with IVA and four eyes were treated with IVR. 5 of 6 eyes in the IVA group and 3 of 4 eyes in the IVR group reminded intraretinal/subretinal fluid after three monthly injections. Multiple linear regression analysis revealed no significant correlations between BCVA, CRT, CCT and GLD, IVR/IVA, subtypes.
Three monthly initial intravitreal anti-VEGF injections could not reach sufficient treatment outcome, i.e., improvement of retinal structure and blocking wet-changes in eyes of AMD with AH. It was possible that AMD with AH was difficult eye for treating with anti-VEGF therapy.