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A novel optical coherence tomography biomarker for anti-VEGF response in classic choroidal neovascularisation

Session Details

Session Title: AMD III

Session Date/Time: Sunday 20/09/2015 | 11:00-13:00

Paper Time: 11:48

Venue: Athena

First Author: : L.Lu UNITED KINGDOM

Co Author(s): :    S. Walker   N. Patel           

Abstract Details

PURPOSE:Classic choroidal neovascularisation appears distinct with the highly reflective subretinal mass on optical coherence tomography (OCT) that co-localises in this lesion type. We used a tumour angiogenesis mathematical model to demonstrate clear linear regression following loading regime phase with anti-vascular endothelial growth factor (anti-VEGF) therapy using OCT caliper measurements. This can be used to differentiate effect from anti-platelet derived growth factor (anti-PDGF) combination therapy when this becomes commercially available.

Setting:

East Kent Hospitals University NHS Foundation Trust, United Kingdom

Methods:

A retrospective observational imaging study of 20 patients treated with anti-VEGF, ranibizumab or aflibercept, for classic choroidal neovascularisation demonstrated by fundus fluorescein angiography (FFA). Spectral domain OCT was used to assess dimensions of the lesion. The ellipsoidal volume of the lesion was calculated using linear caliper measurements to assess the anatomical loading phase response. These patients treated with either intravitreal ranibizumab or aflibercept injections and data analyzed to determine statistical significance of this novel biomarker using MedCalc software.

Results:

Twelve patients received ranibizumab and eight patients received aflibercept injections. All patients had at least 50% clinically significant (p< 0.05) reduction in the ellipsoidal volume, following loading phase therapy. Linear regression analysis confirmed a highly significant relationship (p= 0.001) using this biomarker as a predictor of anatomical resolution following anti-VEGF therapy.

Conclusions:

Anti-VEGF injection therapy results in rapid shrinking of classic CNV lesion size within the retina following loading dose injections of ranibizumab and aflibercept. Using our model, we have successfully identified and quantified a novel reproducible OCT clinical biomarker that can be used to demonstrate improvement for patients treated with anti-VEGF injections and this could help in differentiating tissue response from combination anti-PDGF Injections.

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