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Inner nuclear layer cystoid spaces are a poor prognostic factor in typical age-related macular degeneration and polypoidal choroidal vasculopathy

Authors
 Eui Chun Kang  ;  Seonghee Choi  ;  Hyoung Jun Koh 
Citation
 GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, Vol.255(11) : 2157-2163, 2017 
Journal Title
 GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY 
ISSN
 0721-832X 
Issue Date
2017
MeSH
Aged ; Angiogenesis Inhibitors/administration & dosage ; Cell Nucleus ; Choroid/blood supply* ; Choroid/diagnostic imaging ; Choroid Diseases/complications ; Choroid Diseases/diagnosis* ; Choroid Diseases/drug therapy ; Disease Progression ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fovea Centralis/diagnostic imaging* ; Fundus Oculi ; Humans ; Intravitreal Injections ; Male ; Polyps/complications ; Polyps/diagnosis* ; Polyps/drug therapy ; Prognosis ; Ranibizumab/administration & dosage ; Retrospective Studies ; Time Factors ; Tomography, Optical Coherence ; Visual Acuity* ; Wet Macular Degeneration/complications ; Wet Macular Degeneration/diagnosis* ; Wet Macular Degeneration/drug therapy
Keywords
Age-related macular degeneration ; Choroidal thickness ; Inner nuclear layer cystoid spaces ; Spectral-domain optical coherence tomography
Abstract
PURPOSE: To investigate predictive factors for changes in best-corrected visual acuity (BCVA) at 24 months after intravitreal ranibizumab (IVR) for neovascular age-related macular degeneration (nAMD). METHODS: This retrospective study included 55 eyes of 55 consecutive patients (32 men and 23 women) with nAMD who received three consecutive monthly IVR injections and were re-treated as needed over a 24-month period. We used the mean changes in logarithm of the minimal angle of resolution (logMAR) BCVA at 24 months as the dependent variable in regression analysis. RESULTS: The presence of intraretinal cystoid spaces in the inner nuclear layer (INLc, P = 0.004) and baseline subfoveal choroidal thickness (SFCT, P = 0.013) predicted BCVA changes from baseline to 24 months. The presence of INLc and thinning of SFCT were associated with decreased BCVA at 24 months. Thirty-five eyes without INLc showed improved logMAR BCVA, from 0.550 ± 0.273 to 0.368 ± 0.274 (P = 0.045); however, 20 eyes with INLc showed decreased logMAR BCVA, from 0.708 ± 0.347 to 0.971 ± 0.523 (P < 0.001) through the 24-month follow-up. The mean number of IVR injections during the follow-up period was 8.74 ± 4.76 in eyes without INLc and 10.63 ± 4.72 in eyes with INLc, without a statistically significant difference (P = 0.144). CONCLUSION: Eyes with INLc or thinned SFCT showed worse visual outcomes compared with eyes without the INLc or with thick SFCT. Furthermore, eyes without INLc showed improved BCVA; however, eyes with INLc showed decreased BCVA with an as-needed regimen.
Full Text
https://link.springer.com/article/10.1007%2Fs00417-017-3776-9
DOI
10.1007/s00417-017-3776-9
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eui Chun(강의천)
Koh, Hyoung Jun(고형준) ORCID logo https://orcid.org/0000-0002-5932-8516
Choi, Seo Hee(최서희)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161313
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