Atrophy of retinal vessels in neovascular age-related macular degeneration following long-term treatment with 20 intravitreal anti-VEGF injections
Abstract Background The study aimed to evaluate the changes in retinal vascular density in exudative age-related macular degeneration (AMD) after long-term anti-VEGF treatment using optical coherence tomography angiography (OCT-A), and to compare these changes with the vascular density in AMD treate...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-022-02700-8 |
| _version_ | 1811302053908054016 |
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| author | Miklós D. Resch Aniko Balogh Tilmann Kurth Zoltán Z. Nagy Delia Cabrera DeBuc András Papp |
| author_facet | Miklós D. Resch Aniko Balogh Tilmann Kurth Zoltán Z. Nagy Delia Cabrera DeBuc András Papp |
| author_sort | Miklós D. Resch |
| collection | DOAJ |
| description | Abstract Background The study aimed to evaluate the changes in retinal vascular density in exudative age-related macular degeneration (AMD) after long-term anti-VEGF treatment using optical coherence tomography angiography (OCT-A), and to compare these changes with the vascular density in AMD treated for one year and healthy eyes. Methods In our cross-sectional study OCT-A was performed on 60 eyes of 60 patients. Group AMD 20 × consisted of patients receiving long-term (minimum 20 injections) aflibercept therapy (n = 17), and Group AMD one year consisted of patients treated for one year with a treat & extend protocol (n = 25). The vascular density values obtained with OCT-A were compared with an age-matched control group of 18 healthy eyes. We examined the central retinal thickness (CRT), the vascular density of the fovea and parafovea in the superficial and deep retinal plexus, and evaluated the extent of the non-flow area and the foveal avascular zone (FAZ) on a 3 × 3 mm macular region. Kruskal–Wallis test was performed for statistical analysis. Results In Group AMD 20x, the vascular density of superficial retinal plexus in the fovea (p = 0.0022) and parafovea (p < 0.0001) was significantly lower compared to Group one year and control group. In the deep retinal plexus, vascular density in the fovea (p = 0.0033) was significantly lower in both AMD groups compared to the control group, with no difference in the parafoveal region (p = 0.0774). The extent of non-flow area (p = 0.0003) and FAZ (p = 0.0008) were significantly larger in both AMD groups compared to the control group. There was a significant difference in CRT between those treated for one year and control eyes (p = 0.0036). Conclusions In our study, we demonstrated that macular vessel density was lower in the foveal area in the superficial retinal plexus in AMD patients after one year and long-term anti-VEGF treatment. These vascular density changes were absent in the parafoveal and whole areas of the deep retinal plexus. Our results indicate that long-term anti-VEGF treatment reduces the vascular density of the superficial retinal plexus to a greater extent compared to the deep retinal plexus. |
| first_indexed | 2024-04-13T07:21:04Z |
| format | Article |
| id | doaj.art-35621a2df0944a67addb7a254e803e78 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-04-13T07:21:04Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
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| series | BMC Ophthalmology |
| spelling | doaj.art-35621a2df0944a67addb7a254e803e782022-12-22T02:56:37ZengBMCBMC Ophthalmology1471-24152022-12-012211810.1186/s12886-022-02700-8Atrophy of retinal vessels in neovascular age-related macular degeneration following long-term treatment with 20 intravitreal anti-VEGF injectionsMiklós D. Resch0Aniko Balogh1Tilmann Kurth2Zoltán Z. Nagy3Delia Cabrera DeBuc4András Papp5Department of Ophthalmology, Semmelweis UniversityDepartment of Ophthalmology, Semmelweis UniversityDepartment of Ophthalmology, Semmelweis UniversityDepartment of Ophthalmology, Semmelweis UniversityBascom Palmer Eye Institute, University of Miami Miller School of MedicineDepartment of Ophthalmology, Semmelweis UniversityAbstract Background The study aimed to evaluate the changes in retinal vascular density in exudative age-related macular degeneration (AMD) after long-term anti-VEGF treatment using optical coherence tomography angiography (OCT-A), and to compare these changes with the vascular density in AMD treated for one year and healthy eyes. Methods In our cross-sectional study OCT-A was performed on 60 eyes of 60 patients. Group AMD 20 × consisted of patients receiving long-term (minimum 20 injections) aflibercept therapy (n = 17), and Group AMD one year consisted of patients treated for one year with a treat & extend protocol (n = 25). The vascular density values obtained with OCT-A were compared with an age-matched control group of 18 healthy eyes. We examined the central retinal thickness (CRT), the vascular density of the fovea and parafovea in the superficial and deep retinal plexus, and evaluated the extent of the non-flow area and the foveal avascular zone (FAZ) on a 3 × 3 mm macular region. Kruskal–Wallis test was performed for statistical analysis. Results In Group AMD 20x, the vascular density of superficial retinal plexus in the fovea (p = 0.0022) and parafovea (p < 0.0001) was significantly lower compared to Group one year and control group. In the deep retinal plexus, vascular density in the fovea (p = 0.0033) was significantly lower in both AMD groups compared to the control group, with no difference in the parafoveal region (p = 0.0774). The extent of non-flow area (p = 0.0003) and FAZ (p = 0.0008) were significantly larger in both AMD groups compared to the control group. There was a significant difference in CRT between those treated for one year and control eyes (p = 0.0036). Conclusions In our study, we demonstrated that macular vessel density was lower in the foveal area in the superficial retinal plexus in AMD patients after one year and long-term anti-VEGF treatment. These vascular density changes were absent in the parafoveal and whole areas of the deep retinal plexus. Our results indicate that long-term anti-VEGF treatment reduces the vascular density of the superficial retinal plexus to a greater extent compared to the deep retinal plexus.https://doi.org/10.1186/s12886-022-02700-8Exudative age-related macular degenerationAnti-VEGFLong-term treatmentOptical coherence tomography angiographySuperficial retinal plexusDeep retinal plexus |
| spellingShingle | Miklós D. Resch Aniko Balogh Tilmann Kurth Zoltán Z. Nagy Delia Cabrera DeBuc András Papp Atrophy of retinal vessels in neovascular age-related macular degeneration following long-term treatment with 20 intravitreal anti-VEGF injections BMC Ophthalmology Exudative age-related macular degeneration Anti-VEGF Long-term treatment Optical coherence tomography angiography Superficial retinal plexus Deep retinal plexus |
| title | Atrophy of retinal vessels in neovascular age-related macular degeneration following long-term treatment with 20 intravitreal anti-VEGF injections |
| title_full | Atrophy of retinal vessels in neovascular age-related macular degeneration following long-term treatment with 20 intravitreal anti-VEGF injections |
| title_fullStr | Atrophy of retinal vessels in neovascular age-related macular degeneration following long-term treatment with 20 intravitreal anti-VEGF injections |
| title_full_unstemmed | Atrophy of retinal vessels in neovascular age-related macular degeneration following long-term treatment with 20 intravitreal anti-VEGF injections |
| title_short | Atrophy of retinal vessels in neovascular age-related macular degeneration following long-term treatment with 20 intravitreal anti-VEGF injections |
| title_sort | atrophy of retinal vessels in neovascular age related macular degeneration following long term treatment with 20 intravitreal anti vegf injections |
| topic | Exudative age-related macular degeneration Anti-VEGF Long-term treatment Optical coherence tomography angiography Superficial retinal plexus Deep retinal plexus |
| url | https://doi.org/10.1186/s12886-022-02700-8 |
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