First Author: J.Y.Kim SOUTH KOREA
Co Author(s): Y. Sung You 0 0 0 0 0 0 0 0 0
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To determine the effects of intravitreal anti-vascular endothelial growth factor (anti-VEGF) on the thickness of the retinal nerve fiber layer (RNFL) in patients with age-related macular degeneration.
Chungnam national universiy hospital, daejeon, korea
Twenty eyes of twenty patients diagnosed with age-related macular degeneration who underwent intravitreal anti-VEGF injection were studied. Postinjection RNFL thickness was measured using optical coherence tomography (OCT). The average thickness and four-quadrant RNFL thicknesses in affected eyes were measured before and 6 and 12 months after anti-VEGF injection, for comparison. RNFL thickness in affected and normal counterpart eyes was also compared. Given that macular lesions could affect RNFL thickness, we evaluated the changes in thickness by dividing the 12 clock-hour RNFL into the pathologic area adjacent to the lesion and the non-pathologic area.
The mean number of anti-VEGF injections was 5.0, and the mean clock-hour segment in the pathologic area was 4.8 h. A significantly thicker RNFL was exhibited in temporal quadrants and pathologic areas (p=0.043 and p=0.048, respectively) in affected eyes before injection, compared to baseline RNFL thickness in normal eyes. However, no significant differences were found in RNFL thickness between affected and normal eyes after injection. The changes over time in the temporal and pathologic areas were statistically significant 6 and 12 months after injection, compared to baseline data (p<0.05). No significant differences were displayed in RNFL thickness in the other three quadrants or in non-pathologic areas, in both affected and normal eyes. Also, sequential changes in RNFL thickness in affected eyes were not significant at any time point.
Repeated intravitreal anti-VEGF treatments did not have a significant effect on RNFL thickness overall. However, RNFL thickness significantly decreased with time in the pathologic areas and in the temporal segment adjacent to exudative macular lesions. We therefore conclude that the reduction in RNFL thickness was most likely associated with changes in the macular lesion, rather than with anti-VEGF injection.