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First signs of neovascular age-related macular degeneration requiring anti-VEGF treatment in second eyes under monthly surveillance after treatment in the first eye

Session Details

Session Title: AMD I

Session Date/Time: Friday 12/09/2014 | 08:00-10:00

Paper Time: 08:56

Venue: Boulevard C

First Author: : S.Tavassoli UK

Co Author(s): :    M. Buckle   A. Sallam   R. Johnston        

Abstract Details

Purpose:

To identify the first signs of neovascular age related macular degeneration (nAMD) in the second eye of patients on treatment with anti-VEGF intravitreal injections for their first eye.

Setting:

Ophthalmology Department, Gloucestershire Hospitals, NHS Foundation Trust, Gloucestershire, UK.

Methods:

All patients had monthly review with OCT and fundal examination. At each review a standardised dataset was prospectively recorded within an electronic medical record including: subjective change in vision, ETDRS letter score, central 1mm retinal thickness and the presence or absence of: subretinal fluid (SRF), intraretinal cysts, intraretinal fluid (IRF), new macular haemorrhage, pigment epithelial detachment.

Results:

101 patients developed nAMD in their ‘second’ eye between 2009 and 2012. The first indicator of disease was: a loss of greater than 5 letters since the last visit alone in 27%, the presence of subretinal fluid alone in 8%, the presence of intraretinal fluid or cysts alone in 7%, a 20% increase in retinal thickness since the previous visit alone in 7%, the presence of pigment epithelial detachment alone in 2%, the presence of macular haemorrhage alone in 1%, and other combinations in 48%. A loss of greater than 5 letters since the last visit with other signs in 51%. One of the fluid signs (subretinal fluid, intraretinal fluid or cysts) alone or in combination with each other or other signs in 55%. The mean time from first detection of a new abnormality to first injection was 255 days. The mean visual acuity at detection was LogMAR 0.35. The mean 1mm central macular thickness at first detection of an abnormality was 281mm.

Conclusions:

This study shows that the earliest signs of nAMD in second eyes are most frequently drops in visual acuity with or without the other signs, although these initial signs are often asymptomatic.

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