The University of Southampton
University of Southampton Institutional Repository

Vitreomacular traction affects anti-vascular endothelial growth factor treatment outcomes for exudative age-related macular degeneration

Vitreomacular traction affects anti-vascular endothelial growth factor treatment outcomes for exudative age-related macular degeneration
Vitreomacular traction affects anti-vascular endothelial growth factor treatment outcomes for exudative age-related macular degeneration
Purpose: To evaluate the effect of vitreomacular traction (VMT) on visual acuity outcomes and central retinal thickness (CRT) measurements after intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for treatment of exudative age-related macular degeneration (AMD).

Methods: In this retrospective series, the authors evaluate the clinical records and optical coherence tomography of 34 eyes of 32 patients, with VMT confirmed on optical coherence tomography at baseline, to assess the effects of VMT on anti-VEGF therapy for newly diagnosed exudative wet AMD. Best-corrected visual acuity at baseline, 1, 3, 6, 9, and 12 months and CRT at baseline, 3, 6, and 12 months were assessed. Comparison was made with a control group of 29 eyes of 28 patients with wet AMD and no VMT on optical coherence tomography and with key variable-dosing studies for anti-VEGF in exudative AMD (CATT, HARBOR, PrONTO, SUSTAIN, and Gupta et al).

Results: Best-corrected visual acuity results showed a visual acuity improvement that peaked at 3 months with 2.47 letters, well below other variable-dosing studies for anti-VEGF therapy in exudative AMD. This was then followed by a steady decline with mean best-corrected visual acuity at 12 months ending below the baseline level (-1.00 letters) compared with a gain of 9.39 letters in the control group at 12 months. Comparison of the mean CRT in the VMT group between baseline and 12 months showed no significant difference (P = 0.67), whereas the PrONTO study and control groups showed a highly significant difference at 12 months compared with baseline (P < 0.001). Mean CRT values at 6 months and 12 months were essentially at baseline levels (0.26 µm, -0.62 µm, respectively).

Conclusion: Vitreomacular traction at baseline, existing concurrently with newly diagnosed exudative AMD treated with intravitreal anti-VEGF therapy on a variable-dosing regime, was associated with poorer visual outcomes and a decreased response to reduction in CRT, compared with a control group of wet AMD without VMT and compared with major variable-dosing studies for intravitreal anti-VEGF in exudative AMD.
age-related macular degeneration, anti-vascular endothelial growth factor, exudative, vitreomacular traction
0275-004X
1750-1756
Krishnan, Radhika
b565120e-fead-456d-9f5d-35bbefd82c71
Arora, Rashi
721f0e75-79d2-44e0-b8a1-5df7850658b9
De Salvo, Gabriella
a747876b-c03d-4655-b31c-735e0f2920d2
Stinghe, Alina
d2e76353-e14f-4c8f-9f64-1a6785cf4d1d
Severn, Philip S.
9b6f8328-8517-445d-86db-15b5d06069ec
Pal, Bishwanath
4a9a6abf-435e-4ab4-be9d-5d83cce999dd
Goverdhan, Srinivas
9ae32d5a-5c82-48a4-962d-1ed8acc3991e
Krishnan, Radhika
b565120e-fead-456d-9f5d-35bbefd82c71
Arora, Rashi
721f0e75-79d2-44e0-b8a1-5df7850658b9
De Salvo, Gabriella
a747876b-c03d-4655-b31c-735e0f2920d2
Stinghe, Alina
d2e76353-e14f-4c8f-9f64-1a6785cf4d1d
Severn, Philip S.
9b6f8328-8517-445d-86db-15b5d06069ec
Pal, Bishwanath
4a9a6abf-435e-4ab4-be9d-5d83cce999dd
Goverdhan, Srinivas
9ae32d5a-5c82-48a4-962d-1ed8acc3991e

Krishnan, Radhika, Arora, Rashi, De Salvo, Gabriella, Stinghe, Alina, Severn, Philip S., Pal, Bishwanath and Goverdhan, Srinivas (2015) Vitreomacular traction affects anti-vascular endothelial growth factor treatment outcomes for exudative age-related macular degeneration. Retina, 35 (9), 1750-1756. (doi:10.1097/IAE.0000000000000714).

Record type: Article

Abstract

Purpose: To evaluate the effect of vitreomacular traction (VMT) on visual acuity outcomes and central retinal thickness (CRT) measurements after intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for treatment of exudative age-related macular degeneration (AMD).

Methods: In this retrospective series, the authors evaluate the clinical records and optical coherence tomography of 34 eyes of 32 patients, with VMT confirmed on optical coherence tomography at baseline, to assess the effects of VMT on anti-VEGF therapy for newly diagnosed exudative wet AMD. Best-corrected visual acuity at baseline, 1, 3, 6, 9, and 12 months and CRT at baseline, 3, 6, and 12 months were assessed. Comparison was made with a control group of 29 eyes of 28 patients with wet AMD and no VMT on optical coherence tomography and with key variable-dosing studies for anti-VEGF in exudative AMD (CATT, HARBOR, PrONTO, SUSTAIN, and Gupta et al).

Results: Best-corrected visual acuity results showed a visual acuity improvement that peaked at 3 months with 2.47 letters, well below other variable-dosing studies for anti-VEGF therapy in exudative AMD. This was then followed by a steady decline with mean best-corrected visual acuity at 12 months ending below the baseline level (-1.00 letters) compared with a gain of 9.39 letters in the control group at 12 months. Comparison of the mean CRT in the VMT group between baseline and 12 months showed no significant difference (P = 0.67), whereas the PrONTO study and control groups showed a highly significant difference at 12 months compared with baseline (P < 0.001). Mean CRT values at 6 months and 12 months were essentially at baseline levels (0.26 µm, -0.62 µm, respectively).

Conclusion: Vitreomacular traction at baseline, existing concurrently with newly diagnosed exudative AMD treated with intravitreal anti-VEGF therapy on a variable-dosing regime, was associated with poorer visual outcomes and a decreased response to reduction in CRT, compared with a control group of wet AMD without VMT and compared with major variable-dosing studies for intravitreal anti-VEGF in exudative AMD.

PDF
Retina Accepted Manuscript.pdf - Accepted Manuscript
Download (2MB)

More information

Accepted/In Press date: 6 June 2015
Published date: September 2015
Keywords: age-related macular degeneration, anti-vascular endothelial growth factor, exudative, vitreomacular traction
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 378920
URI: https://eprints.soton.ac.uk/id/eprint/378920
ISSN: 0275-004X
PURE UUID: 3ce278f5-3d36-45bf-97df-addaeb8cd303

Catalogue record

Date deposited: 21 Jul 2015 12:29
Last modified: 17 Jul 2017 20:48

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×