Effect on the vitreomacular interface after repeated anti-vascular endothelial growth factor treatment in patients with exudative age-related macular degeneration / 中华眼底病杂志

ABSTRACT

Objective To observe the effects of repeated intravitreal injections of anti-vascular endothelial growth factor (VEGF) drugs on vitreous macular interface (VMI) in patients with exudative age-related macular degeneration (AMD).Methods Retrospective study.Thirty-four exudative AMD patients who treated with intravitreal anti-VEGF drugs were included in this study.There were 26 males and 8 females.The age ranged from 50 to 80 years,with the average of (62.8± 8.35) years.The eyes with at least 6 treatments during the 1-year follow-up were taken as the study eyes,and the eyes with no anti-VEGF drug treatment were the control eyes.Optical coherence tomography (OCT) examination was used to observe the VMI status of both eyes before treatment.Vitreous macular adhesion (VMA),macular epiretinal membrane (MEM),and complete vitreous detachment (C-PVD) were defined as abnormalities in VMI.The VMA was classified as focal (≤ 1500 μrn) and broad (＞ 1500 μtm) depending on the diameter of the vitreous and macular adhesions on the OCT images.Before treatment,there were 12 eyes with abnormal VMI in study eyes,including 8 eyes with broad VMA,3 eyes with focal VMA,and 1 eye with MEM;12 eyes with abnormal VMI in control eyesbroad VMA in 7 eyes,focal VMA in 2 eyes,C-PVD in 2 eyes,and MEM in 1 eye.The average follow-up time after treatment was 16.4 months.During the follow-up period,OCT was performed monthly in a follow-up mode.Comparing the changes on VMI between before and after treatment in both eyes of patients,respectively.The chi-square test was used to compare the difference on VMI.Because the number of samples was ＜40,Fisher's exact test was used for the analysis.Results At the final follow-up,12 eyes with abnormal VMI in the study eyes,including 5 eyes with broad VMA,2 eyes with focal VMA,3 eyes with C-PVD,and 2 eyes with MEM.There were 6 eyes altered comparing with baseline.In the control eyes,there were 13 eyes with abnormal VMI,including 5 eyes with broad VMA,7 eyes with C-PVD,and 1 eye with MEM.A total of 6 eyes changed on VMI comparing with baseline.At the final follow-up,there was no significant difference on VMI changes between the study eyes and its corresponding control eyes (P=0.053).In all eyes,a total of 4 eyes changed from focal VMA to C-PVD at the final follow-up,accounting for 80.0％ of the total focal VMA;3 eyes changed from broad VMA to C-PVD,accounting for 21.4％ of the total broad VMA.Conclusions Repeated anti-VEGF treatment has little effect on VMI.Regardless of anti-VEGF therapy,eyes with focal VMA appears to be more prone to C-PVD than the broad one.