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EXACERBATION OF CHOROIDAL AND RETINAL PIGMENT EPITHELIAL ATROPHY AFTER ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

Young, Mei MASc*; Chui, Lica MD*; Fallah, Nader PhD; Or, Chris BSc*; Merkur, Andrew B. MD*; Kirker, Andrew W. MD*; Albiani, David A. MD*; Forooghian, Farzin MD, FRCSC*

doi: 10.1097/IAE.0000000000000081
Original Study
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Purpose: To study the progression of retinal pigment epithelium (RPE) and choroidal atrophy in patients with neovascular age-related macular degeneration (AMD) and to assess for a possible association with the number and type of anti–vascular endothelial growth factor treatments.

Methods: Patients with neovascular AMD and a minimum of 1-year follow-up were reviewed. Fellow eyes with nonneovascular AMD were used as control eyes. Retinal pigment epithelial atrophy area and choroidal thickness were determined using spectral-domain optical coherence tomography. Multivariable regression models were used for statistical analyses.

Results: A total of 415 eyes were included in the study, with a mean follow-up of 2.2 years. Eyes with neovascular AMD had greater progression of RPE atrophy and choroidal atrophy compared with those with nonneovascular AMD (P < 0.001). Progression of RPE atrophy and choroidal atrophy was independently associated with the total number of injections of bevacizumab and ranibizumab (all P values ≤ 0.001). In the subgroup of 84 eyes with neovascular AMD and without RPE atrophy at baseline, only bevacizumab was associated with the progression of RPE atrophy (P = 0.003). This study likely lacked statistical power to detect an association with ranibizumab in this subgroup.

Conclusion: Retinal pigment epithelial atrophy and choroidal atrophy in neovascular AMD seem to be exacerbated by anti–vascular endothelial growth factor treatment. Possible differences between bevacizumab and ranibizumab require further investigation.

In this retrospective study of more than 400 eyes with a mean follow-up of >2 years, the authors found an association between intravitreal anti–vascular endothelial growth factor therapy and the progression of retinal pigment epithelium and choroidal atrophy in patients with neovascular age-related macular degeneration.

*Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada; and

Rick Hansen Institute, Vancouver, BC, Canada.

Reprint requests: Farzin Forooghian, MD, FRCSC, Department of Ophthalmology and Visual Sciences, University of British Columbia, St. Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada; e-mail: farzin.forooghian@gmail.com

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.