Photoreceptor integrity may help predict treatment response in AMD patients

Am J Ophthalmol. 2012;154(1):164-173.

  • August 22, 2012

Visual acuity in eyes with age-related macular degeneration may be predicted with the status of photoreceptor integrity, according to a study.

The retrospective review analyzed 87 eyes of 84 patients with neovascular AMD who were treated with anti-VEGF injections.

All patients received three consecutive monthly anti-VEGF injections, followed by as-needed dosing. Spectral domain optical coherence tomography (SD-OCT) images were taken at baseline and at 1 and 2 months after the three monthly injections.

The status of the inner segment/outer segment (IS/OS) photoreceptor junction was classified into three groups. The IS/OS+ group had a nearly intact IS/OS line and disruptions less than 200 µm. The IS/OS± group had disruptions between 200 µm and 800 µm. The IS/OS– group had disruptions greater than 800 µm.

Patients were redistributed among the three groups based on the SD-OCT images taken at the three time intervals.

Between baseline and 1 month, a significant difference existed in the ratio of the IS/OS+ group (P < .001). Better visual acuity and an improvement of the IS/OS line was seen in 43 eyes from baseline to 1 month (P < .016).

Although better visual acuity was significantly correlated to the status of the IS/OS line at 1 month and 2 months, better visual acuity at follow-up did not correlate to the status of the IS/OS line at baseline.

No significant difference existed in the IS/OS line between 1 month and 2 months. No further improvement was detected at 2 months.

“Assessing the change of the photoreceptor integrity before and after treatment would be a useful indicator to predict initial response to treatment and visual prognosis in patients with neovascular AMD,” the study authors said.

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