First Author: J.Montero-Hernandez SPAIN
Co Author(s): V. Castro-Navarro C. Navarro-Palop L. Mata-Moret E. Cervera-Taulet
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It is known that the functional and structural status of the choroid is closely associated with the development of AMD. Additionally, choroidal thickness appeared to decrease after intravitreal aflibercept injections in eyes with neovascular AMD. Our objective is to investigate changes in the macular choroidal thickness in patients with retinal angiomatous proliferation treated with aflibercept according to a treat-and-extend (TAE) regimen and its correlation with visual acuity.
Retrospective nonrandomized cohort study performed in eight eyes of eight patients with retinal angiomatous proliferations (RAP).
Patients with RAP were treated with three monthly 2 mg aflibercept injections followed by a TAE approach. RAP stages were classified according to Yannuzzi’s original staging of disease progression. Main outcome measures included changes in best-corrected visual acuity (BCVA) and quantitative and qualitative analysis with Spectral-domain optical coherence tomography (SD-OCT) recorded at baseline, 3, 6 and at 12 months. Choroidal thickness (CT) was considered to be the length between the outer border of the Bruch membrane and chorioescleral interface, and was manually measured centreed on fovea, 500 µm nasally and temporally. Statistical significance was defined as (p<0.05).
Patients received a mean of 7.37±0.7 aflibercept injections. Regarding functional outcomes, BCVA significantly improved from 0.57 ± 0.24 LogMAR to 0.38 ± 0.43 LogMAR. Baseline CT centreed on fovea, 500 µm nasally and temporally were 221±19.83µ, 193.25±24.22µ and 234.62±18.3, respectively. A progressive reduction in CT occurred in all localizations with final values of 164.12±43.05µ at fovea, 157.75±47.97µ at 500 µm nasally and 172.37±40.11µ at 500 µm temporally. Most of the decline occurred between the 3 and 6 months evaluations in all the localizations with a maximum decrease of 32µ. The final percentage decrease compared with baseline was 25.79% measured at fovea. No correlation was found between change in mean subfoveal choroidal thickness and BCVA at 12 months .
Our results demonstrate a decreased in CT in eyes with RAP treated with aflibercept at 12 months evaluation. CT decreased not only at the foveal centre, but also in the entire macula with most of the decline occurring in the first 6 months. No correlations were found between CT changes and visual outcomes.