To determine baseline factors that can predict the response of pigment epithelial detachments (PEDs) in neovascular age-related macular degeneration to treatment with intravitreal bevacizumab (IVB).
Patients with newly diagnosed neovascular age-related macular degeneration and PED who were treated exclusively with IVB were included. Response to treatment was defined by change in PED volume (determined using spectral-domain optical coherence tomography). PEDs were classified as either predominantly serous or fibrovascular. Multivariable regression and receiver operating characteristic analyses were performed.
A total of 48 eyes were identified (mean follow-up time 73 weeks). Overall, the response to the first IVB treatment was predictive of the response to treatment at the final visit (P = 0.015). Serous PEDs had a greater decrease in volume at the final visit (P = 0.008). With respect to both PED types, a decrease in PED volume of 21% after the first IVB treatment was predictive of an overall decrease in volume of 30% at the final visit (sensitivity 83%, specificity 76%).
In neovascular age-related macular degeneration, serous PEDs respond more favorably to IVB than fibrovascular PEDs. Overall, for both types of PED, the response to the first treatment is predictive of the final response to treatment. Taken together, the results would suggest that if there is less than 21% reduction in PED volume after the first IVB treatment, and/or the PED is predominantly fibrovascular, then switching to another antivascular endothelial growth factor agent should be considered.
The authors used OCT-based volumetric assessment to determine factors that predict response of pigment epithelial detachments in neovascular age-related macular degeneration to treatment with intravitreal bevacizumab. Predominantly serous pigment epithelial detachments responded more favorably. Also, the initial response to the first treatment was predictive of the overall final response to treatment.
Departments of *Ophthalmology, and
†Medicine, University of British Columbia, Vancouver, BC, Canada.
Reprint requests: Farzin Forooghian, MD, MSc, FRCSC, Department of Ophthalmology, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; e-mail: firstname.lastname@example.org
This study was funded by a grant from the Retina Foundation of Canada.
None of the authors have any financial/conflicting interests to disclose.