Retina & Vitreous

OCT Findings Predict Visual Outcome of Macular Disease

Avatar photoStephen J. Bohacik
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Ophthalmology office.
Ophthalmology office. Masked patient and doctor – Covid 19. Scan of the retina, an examination that allows you to precisely visualize the different parts of the eye. This imaging makes it possible to observe the retina in order to detect, for example, a retinal uplift with edema or a diabetic retinopathy. It is used to monitor wet AMD about every two months and complements the fundus to see if an injection of treatment is needed. OCT is also used to examine the optic nerve, and therefore screen for or monitor glaucoma. (Photo by: Pascal Bachelet/BSIP/Universal Images Group via Getty Images)
Clinicians may be able to offer a better visual prognosis for patients with type 3 macular neovascularization who receive anti-VEGF injections, a study suggests.

Researchers have identified 4 structural OCT features that may be associated with long-term best-corrected visual acuity (BCVA) outcomes in patients with Type 3 macular neovascularization (MNV), according to research published in Ophthalmology Retina. After 3 years of treatment with anti-vascular endothelial growth factor (anti-VEGF) injections, they found that baseline BCVA, the presence of subretinal fluid (SRF), the number of active lesions, and central macular thickness (CMT) were linked with long-term BCVA outcome. 

Investigators conducted a retrospective, longitudinal analysis of 40 eyes of 30 patients diagnosed with type 3 MNV (mean age 79±6 years, 21 pseudophakic, 21 women) who were treated with anti-VEGF injections (mean number of injections 10.1±4.7) and had a minimum follow-up of 3 years. They obtained baseline measurements of BCVA, mean CTM, subfoveal choroidal thickness (ChT), sublesion ChT, and mean ChT (0.34±0.28 logMAR, 408±138 µm, 176±81 µm, 177±84 µm, and 175±81 µm, respectively).

Overall, mean BCVA within the cohort decreased to 0.52±0.37 logMAR at 3 year follow-up (P =.002). Univariate analysis revealed that baseline BCVA, foveal involvement of exudation, and the presence of SRF (P =.004 for all) were associated with the 3 year BCVA outcome. Multivariate models showed independent associations between BCVA outcomes and baseline BCVA (ꞵ=0.335, P =.032), CMT (ꞵ=-0.383, P =.036), number of active T3 lesions (ꞵ=-0.284, P =.034), and presence of SRF (ꞵ=0.433, P =.008).

“The analysis of possible predictors of anatomical and functional outcome is very useful in order to better customize the treatment of each patient,” according to the investigators. The study highlights their finding that “baseline BCVA and several structural OCT biomarkers (i.e. CMT, number of active lesions, and SRF) are associated with long-term BCVA outcome after 3-year treatment with anti-VEGF injections.”

Study limitations include a retrospective, single center design, small sample size, and ethnic homogeneity among participants.

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Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or clinical research organizations. Please refer to the original article for a full list of disclosures.

Reference

Sacconi R, Forte P, Tombolini B, et al. Optical coherence tomography predictors of 3 year visual outcome for type 3 macular neovascularization. Ophthalmol Retina. Published online February 25, 2022. doi:10.1016/j.oret.2022.02.010

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