Changes in central subfield thickness may account for only a low percentage of total variations in visual acuity changes, according to findings published in JAMA Ophthalmology.
Neil M. Bressler, MD, and colleagues determined that changes in OCT central subfield thickness (OCT CST) do not accurately indicate changes in visual acuity in patients undergoing anti-VEGF treatment.
The researchers examined the data of 652 participants (median age, 61 years; 46.6% women) receiving six monthly intravitreal anti-VEGF injections over 3 years. The main outcomes were the association between changes in visual acuity letter score with changes in CST at intervals of 12 weeks, 1 year and 2 years after randomization to aflibercept, bevacizumab or ranibizumab.
Bressler and colleagues identified the correlation between CST and visual acuity at the follow-ups at 12 weeks in 616 patients (0.24; 95% CI, 0.16-0.31) and 609 patients in 1 year (0.31; 95% CI, 0.24-0.38). At the 2-year follow-up mark, the CST-visual acuity correlation in 566 patients was 0.23 (95% CI; 0.15-0.31).
In the same follow-up periods, the correlation coefficients of change in visual acuity vs. change in OCT CST was 0.36 (95% CI; 0.29-0.43) at 12 weeks and 1 year and 0.33 (95% CI; 0.26-0.41) at 2 years, the researchers wrote.
“These findings do not support using changes in OCT CST in lieu of changes in visual acuity in phase 3 clinical trials evaluating anti-VEGF treatments for diabetic macular edema and suggest that OCT CST changes are not typically a reliable guide to informing a physician or patient about changes in visual acuity with anti-VEGF treatment for an individual eye,” Bressler and colleagues wrote. – by Earl Holland Jr.
Disclosures: Bressler reports receiving grants from the National Eye Institute during the study as well as grants from Bayer, Genentech/Roche, Novartis and Samsung Bioepis. Please see the study for all other authors’ relevant financial disclosures.