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A Pilot Post Hoc Analysis of Patients With Pigment Epithelial Detachments

Rebhun, Carl B., MD*; Moreira-Neto, Carlos, MD, PhD*; Gune, Shamika, MD; Hill, Lauren, MS; Duker, Jay S., MD*; Waheed, Nadia K., MD, MPH*

doi: 10.1097/IAE.0000000000002402
Original Study: PDF Only

Purpose: To determine optical coherence tomography signs associated with macular atrophy (MA) in eyes with neovascular age-related macular degeneration and pigment epithelial detachments treated with vascular endothelial growth factor inhibitors.

Methods: Optical coherence tomography scans from a subgroup of the pigment epithelial detachment cohort of the HARBOR study were analyzed for MA. Two groups were formed based on MA presence/absence at Month 24. Then, optical coherence tomography scans from each baseline visit were graded with standard reading center grading parameters including ellipsoid zone disruption, intraretinal cysts, subretinal fluid, and MA or nascent MA in the study and fellow eyes.

Results: Twenty-eight eyes from 28 patients were included in the analysis. Fourteen eyes had optical coherence tomography–based MA at Month 24 and 14 did not. Macular atrophy at Month 24 was significantly associated with 1) MA/nascent MA at baseline (P = 0.0136), 2) intraretinal cysts at baseline (P = 0.0048), and 3) collapse of pigment epithelial detachments in the study eye (P = 0.0025). Macular atrophy was not associated with ellipsoid zone disruption or subretinal fluid in the study eye at baseline.

Conclusion: This study suggests that some optical coherence tomography findings in eyes of patients with neovascular age-related macular degeneration were present before the start of anti–vascular endothelial growth factor therapy and may predict the development of MA.

Optical coherence tomography allows for the visualization of signs that may be predictive of macular atrophy in eyes with neovascular age-related macular degeneration treated with vascular endothelial growth factor inhibitors.

*New England Eye Center, Tufts Medical Center, Boston, Massachusetts; and

Genentech, Inc., South San Francisco, California.

Reprint requests: Nadia K. Waheed, MD, MPH, New England Eye Center, Tufts Medical Center, 260 Tremont Street, Biewend Building, 9–11th Floor, Boston, MA 02116; e-mail:

N.K. Waheed receives funding from a grant awarded by the Macula Vision Research Foundation. The sponsor of the HARBOR study contributed to the study design, supplied image data, provided statistical support, and critically reviewed and approved the manuscript for publication, but had no role in the conduct of this research or final clinical interpretation of the data.

Presented at the Retina Society Annual Meeting, San Diego, CA, September 17, 2016.

S. Gune and L. Hill are employees of Genentech, Inc. J.S. Duker received financial support from Carl Zeiss Meditec, Inc., Optovue Inc., and Topcon. N.K. Waheed consulted for Carl Zeiss Meditec, Inc., Genentech, Inc., Iconic Therapeutics, Optovue, and Regeneron. The remaining authors have no financial/conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.