August 21, 2014
1 min read

Identification of ORT after anti-VEGF treatment for neovascular AMD critical

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Identification of eyes with outer retinal tabulations after anti-VEGF therapy for neovascular age-related macular degeneration is important, as these eyes have worse visual acuity outcomes than those without this finding, according to researchers.

In a prospective cohort study of a segment of patients included in the CATT, researchers obtained spectral-domain optical coherence tomography (SD-OCT) images using the Cirrus HD-OCT (Carl Zeiss Meditec) or Spectralis system (Heidelberg Engineering) at weeks 56 and 104 after initiation of anti-VEGF treatment for neovascular age-related macular degeneration.

Independent readers graded the scans to identify prevalence of outer retinal tabulations (ORTs), which was defined as presence of tubular structures on at least three consecutive Cirrus B scans or two consecutive Spectralis B scans. The researchers then used univariate and multivariate analyses to evaluate associations of patient-specific and ocular features at baseline and follow-up with ORT.

At week 56, seven of 69 eyes were found to have ORTs, whereas 69 of 368 eyes were found to have ORTs at week 104. The researchers found that absence of diabetes, poor VA, blocked fluorescence, geographic atrophy, greater lesion size and presence of subretinal hyperreflective material at baseline were each independently associated with having a greater risk of ORT presence at week 104.

Neither drug type nor dosing regimen had significant associations with development of ORTs, according to the researchers.

At week 104, eyes with ORTs had significantly worse VA than eyes without ORTs (58.5 letters vs. 68.8 letters, respectively).

Disclosure: The authors have no relevant financial disclosures.