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A quantitative approach to identify morphological features relevant for visual function in ranibizumab therapy of neovascular AMD.

著者 Roberts P , Mittermueller TJ , Montuoro A , Sulzbacher F , Munk MR , Sacu S , Schmidt-Erfurth U この記事をPubMed上で見るPubMedで表示
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Purpose: To quantitatively analyze morphological features in eyes with neovascular age-related macular degeneration (nAMD) at baseline, after 12 months and after 24 months of intravitreal ranibizumab treatment and to perform a structure/function correlation. Design: Observational case series Methods: Eyes with treatment-naïve nAMD were treated with intravitreal ranibizumab according to a standardized dosing regimen over two years and followed continuously in a prospective study design. The central foveal area of 1000µm (horizontal) x 960µm (vertical) of SD-OCT volume scans was evaluated quantitatively (using proprietary software) for the following pathologies: Alteration of the external limiting membrane (ELM), alteration of the ellipsoid zone, subretinal fluid, pigment epithelium detachment, drusen, intraretinal cysts, subretinal mass and sub-retinal pigment epithelium mass. The total area of each pathology was calculated in mm² at baseline and after one and two years of ranibizumab-therapy and correlated with BCVA results. Results: In total, 480 central SD-OCT scans of 20 consecutive patients were evaluated. In the multivariate regression analysis the area of ELM alteration, the area of intraretinal cysts and foveal retinal thickness were significant variables influencing visual acuity at baseline (R= -0.827; R²= 0.684; p< 0.001). The area of ELM alteration was the only significant factor to be directly associated with visual acuity at 12 months (R= -0.846; R²= 0.716; p<0.001) and 24 months (R= -0.778; R²= 0.606; p<0.001). Conclusions: The integrity of the ELM appears to be the most important feature correlating with visual acuity in native nAMD as well as nAMD treated with intravitreal ranibizumab at each time interval, but not prospectively. In general, no significant predictors for an individual gain or loss in mid- (12 months) or long-term BCVA-results (24 months) were found by OCT.
PMID: 25190663 [PubMed - as supplied by publisher]
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