We aimed to assess the relationship of repeated intravitreal injection of anti–vascular endothelial growth factor, the main treatment for exudative age-related macular degeneration, with changes in vitreous ultrasonographic findings in patients with age-related macular degeneration.
We retrospectively collected data from 41 patients (41 age-related macular degeneration eyes, 41 control eyes) on age, sex, number of injections, and type of anti–vascular endothelial growth factor (ranibizumab, aflibercept). Ocular ultrasonography was performed with open eyelids, under topical anesthesia, and using carbomers as ultrasonographic gel. Topographic, quantitative, and kinetic ultrasonography was performed in all eye quadrants using a 10-MHz posterior pole probe, and vitreous reflectivity was assessed.
The mean age of patients was 79 (range: 59−94) years, with a mean of five intravitreal anti–vascular endothelial growth factor injections (range: 1−13). No significant ultrasonographic differences were found relative to the incidence of partial or complete posterior vitreous detachment. Vitreous hyperechogenicity increased in the treated eye (P < 0.001), and the vitreous reflectivity range increased with the number of injections (P = 0.041, R2 = 0.214). However, the type of anti–vascular endothelial growth factor used and the time elapsed since the last intravitreal injection was not significant (P > 0.05).
These preliminary results indicate a proportional increase in ultrasonographic reflectivity of vitreous gel with the number of injections.
Ultrasound investigation demonstrates that the vitreous cavity of eyes of patients with age-related macular degeneration who were treated with intravitreal antiangiogenic agent injections shows greater reflectivity, suggesting that intravitreal injections alter the vitreous cavity.
Department of Ophthalmology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Reprint requests: Manuel F. Bande, MD, PhD, Department of Ophthalmology, Complexo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain; e-mail: firstname.lastname@example.org
None of the authors has any financial/conflicting interests to disclose.
M. F. Bande and T. Mato-Gondelle contributed equally to this manuscript.