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Acta Chirurgica Latviensis

The Journal of Riga Stradins University; Latvian Association of Surgeons; Latvian Association of Paediatric Surgeons

2 Issues per year

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Online
ISSN
2199-5737
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Progression of Retinal Pigment Epithelium Atrophy in Patients with Long-Term Anti-Vegf Treatment for Exudative Age-Related Macular Degeneration

Lita Jekabsone / Anete Kursite
  • Riga Stradins University, Riga, Latvia
  • Department of Ophthalmology, Pauls Stradins Clinical University Hospital, Riga, Latvia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Oskars Gertners
  • Riga Stradins University, Riga, Latvia
  • Department of Ophthalmology, Pauls Stradins Clinical University Hospital, Riga, Latvia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Guna Laganovska
  • Riga Stradins University, Riga, Latvia
  • Department of Ophthalmology, Pauls Stradins Clinical University Hospital, Riga, Latvia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2018-09-25 | DOI: https://doi.org/10.1515/chilat-2017-0016

Abstract

Introduction.Age-related macular degeneration is the leading cause of visual impairment in developed world. The reason for using intravitreal injections of anti-vascular endothelial growth factor (VEGF) is to prevent choroidal neovascularization which is the main pathogenic mechanism for exudative age-related macular degeneration. Although injections may improve visual acuity, there are evidence showing association of anti-VEGF injections with progression of retinal pigment epithelium (RPE) atrophy. Aim of the Study.The purpose of this study was to investigate the intravitreal anti-vascular endothelial growth factor impact on retinal pigment epithelium atrophy development and progression. Material and methods.A single-centre retrospective study was conducted. Total 51 eyes of 39 patients with exudative age-related macular degeneration undergoing intravitreal anti-vascular endothelial growth factor therapy for 48 months. Heidelberg Spectralis Optical Coherence Tomography and fundus autofluorescence were used for evaluation of retinal pigment epithelium atrophy area and retinal thickness. Measurements were made manually. Best-corrected visual acuity (BCVA) measurements were taken from patient medical histories. For statistical analysis, IBM Statistical Package for the Social Sciences, version 23.0 was used. Results.The average age of patients was 81.6 ± 6.7 years. After first year of intravitreal anti-VEGF therapy, retinal pigment epithelium atrophy area enlarged from baseline (from 1.91 ± 2.3 mm2 to 2.74 ± 2.3mm2, p < 0.001). The mean number of intravitreal anti- VEGF injections received in 48 months was 15.47 ± 5.14. There was a statistically significant correlation between total number of intravitreal injections and RPE atrophy (R = 0.757, p < 0.001). After first year of anti-VEGF therapy best-corrected visual acuity (decimals) was statistically improved from baseline (0.32 ± 0.26 to 0.37 ± 0.24, p = 0.04). However, despite significant improvement at first year, the further treatment contributed BCVA reduction. Conclusions.Retinal pigment epithelium atrophy is a frequent finding in eyes with exudative age-related macular degeneration before and after anti-VEGF therapy. Our data show statistically significant association between total number of intravitreal anti-VEGF injections and retinal pigment epithelium atrophy area enlargement. Also there was statistically significant best-corrected visual acuity improvement after first year of anti-VEGF therapy.

Keywords: age-related macular degeneration; retinal pigment epithelium; atrophy; best-corrected visual acuity

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About the article

Published Online: 2018-09-25

Published in Print: 2017-12-20


Citation Information: Acta Chirurgica Latviensis, Volume 17, Issue 2, Pages 9–13, ISSN (Online) 2199-5737, DOI: https://doi.org/10.1515/chilat-2017-0016.

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© 2018 Lita Jekabsone, published by Sciendo. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License. BY-NC-ND 4.0

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