Longitudinal correlation of spectral domain optical coherence tomography parameters, angiographic features and visual acuity in patients with exudative age-related macular degeneration during intravit

Abstract

[한글]

[영문]Purpose: To identify anatomic parameters offering a prognostic value for visual acuity(VA) and to quantitatively and qualitatively evaluate the relationship among spectral domain optical coherence tomography(sd-OCT) derived measurement of retinal morphology, fluorescein angiogram(FA) retinal parameters and VA in neovascular age-related macular degeneration(AMD) patients treated with three consecutive monthly intravitreal Ranibizumab injections.Methods: We retrospectively reviewed 51 eyes of 51 patients with primary as well as previously treated patients with subfoveal CNV secondary to AMD. Of those, 33 eyes with neovascular AMD were enrolled and longitudinally analyzed for monthly sd-OCT, FA and VA using a linear mixed model for both qualitative and quantitative measures during three monthly intravitreal ranibizumab therapiesResults: Longitudinal correlational analysis using a linear mixed model demonstrated that decreased central retinal thickness(CRT) and central retinal volume(CRV) were found to be significantly correlated with increased VA (r=5.58x10-4, r=0.802 , p<0.05). Furthermore, decreased CRT and CRV (r=17.66, r=0.0137, p<0.0001), and qualitative parameters of CNV activity by sd-OCT were also associated with reduced CNV leakage in FA(p<0.05). Conclusions: Clinically significant diagnostic parameters of sd-OCT to correlate with the change in VA and angiographic features during three consecutive monthly intravitreal ranibizumab therapy were identified. CRV and CRT measured by sd-OCT demonstrated treatment related correlation with change in VA. These factors accounted for substantial portion of improvement in VA while patients undergo initial therapeutic phase. A significant correlation between FA leak area and sd-OCT activity parameters were also demonstrated.