Regression of choroidal neovascularization results in macular atrophy in anti-vascular endothelial growth factor-treated eyes. Am J Ophthalmol 2015 Jan;159(1):9-19.e1-2
Date
09/15/2014Pubmed ID
25217857Pubmed Central ID
PMC10020832DOI
10.1016/j.ajo.2014.09.012Scopus ID
2-s2.0-84920735881 (requires institutional sign-in at Scopus site) 49 CitationsAbstract
PURPOSE: To determine the incidence and progression of macular atrophy in patients with neovascular age-related macular degeneration (AMD) treated with vascular endothelial growth factor (VEGF) antagonists.
DESIGN: Retrospective interventional case series.
METHODS: All patients with neovascular AMD treated by the same physician during a 12-month period of ascertainment had all images from their entire follow-up period evaluated, and areas of retina that developed atrophy were compared to the same areas prior to the onset of anti-VEGF treatment. Longitudinal measurements of retinal atrophy were made.
RESULTS: In 39 patients, 52 eyes with neovascular AMD were identified. We excluded 5 eyes from analysis (4 had retinal pigment epithelium tears, and 1 had a laser scar). Fundus photographs of the remaining eyes showed that 18/47 eyes (38%) contained hypopigmented areas suggestive of atrophy within the macula at some time during follow-up. Spectral-domain optical coherence tomography confirmed that these areas had loss of retinal pigmented epithelium and ellipsoids zones, with or without subretinal material suggestive of subretinal fibrosis. Comparison of fundus photographs with fluorescein angiograms showed that in 13/18 eyes (72%), atrophy developed in areas previously occupied by choroidal neovascularization, and the other 5 eyes had atrophy prior to the onset of anti-VEGF treatment. The mean (± standard deviation) rate of increase in pure atrophic areas (no subretinal material) was 0.7 ± 0.8 mm(2) per year, with a range of 0.01-2.6 mm(2)/year.
CONCLUSION: Treatment of neovascular AMD with a VEGF-neutralizing protein can result in regression of choroidal neovascularization, which is sometimes associated with atrophy of overlying retina.
Author List
Channa R, Sophie R, Bagheri S, Shah SM, Wang J, Adeyemo O, Sodhi A, Wenick A, Ying HS, Campochiaro PAMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Angiogenesis Inhibitors
Antibodies, Monoclonal, Humanized
Bevacizumab
Choroidal Neovascularization
Disease Progression
Female
Humans
Incidence
Macula Lutea
Macular Degeneration
Male
Ranibizumab
Remission Induction
Retrospective Studies
Tomography, Optical Coherence
Vascular Endothelial Growth Factor A
