Association between choroidal thickness and the response to intravitreal ranibizumab injection in age-related macular degeneration

Acta Ophthalmol. 2015 Sep;93(6):524-32. doi: 10.1111/aos.12653. Epub 2015 Jan 11.

Abstract

Purpose: To investigate the relationship between the choroidal thicknesses of eyes of patients with age-related macular degeneration (AMD) and the outcomes of intravitreal ranibizumab injection.

Methods: We reviewed the medical records of 141 consecutive eyes (80 with typical neovascular AMD and 61 with polypoidal choroidal vasculopathy [PCV]) treated by intravitreal ranibizumab and 121 normal control eyes matched in terms of age and spherical equivalent (SE). Eyes of patients were divided into three subgroups with thin, medium and thick choroids. We investigated the relationships between choroidal thickness and treatment outcomes of intravitreal ranibizumab.

Results: In eyes with typical neovascular AMD, thin choroids were associated with older age (linear regression; p < 0.0001) and larger choroidal neovascularization (CNV) lesions (p = 0.049). Patients with thin choroids had a higher prevalence of intra-/subretinal fluid (generalized estimated equation; thin versus medium p < 0.0001; thin versus thick p = 0.003), and less visual gain from baseline to 12 months after treatment, than did other subgroups (linear mixed model; thin versus medium p < 0.0001; thin versus thick p = 0.023). PCV eyes with thick choroids more often had retinal fluid, and eyes with thin choroids experienced more frequent resolution of retinal fluid, from baseline to 12 months after treatment (thick versus medium p < 0.0001, thick versus thin p < 0.0001, thin versus medium p = 0.001). No intergroup difference in post-treatment functional outcome was noted in eyes with PCV (p = 0.584).

Conclusions: Subfoveal choroidal thickness was associated with functional and anatomical outcomes after intravitreal ranibizumab injection in eyes with typical neovascular AMD and PCV.

Keywords: age-related macular degeneration; antivascular endothelial growth factor; choroidal thickness; optical coherence tomography; polypoidal choroidal vasculopathy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use*
  • Choroid / pathology*
  • Choroidal Neovascularization / drug therapy
  • Choroidal Neovascularization / physiopathology
  • Female
  • Humans
  • Intravitreal Injections
  • Male
  • Organ Size
  • Polyps / drug therapy
  • Polyps / physiopathology
  • Ranibizumab / therapeutic use*
  • Retrospective Studies
  • Subretinal Fluid
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology
  • Wet Macular Degeneration / drug therapy*
  • Wet Macular Degeneration / physiopathology

Substances

  • Angiogenesis Inhibitors
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Ranibizumab