Abstract
Objective
To establish whether increased variability in macular thickness in neovascular age-related
macular degeneration (nAMD) patients affects visual outcomes in clinical practice
Design
Retrospective cohort study
Participants
Treatment-naive nAMD patients studied over 24 months
Methods
Central subfield thickness (CST) values from optical coherence tomography were collected
quarterly from baseline to 24 months, and standard deviations (SDs) were calculated.
The relationship was modeled with mixed-effects regression between CST SD and 24-month
change in visual acuity (VA). Linear regression modeling determined predictors of
CST SD.
Results
A total of 422 eyes with nAMD were studied. Baseline and 24-month CST values (mean
± SD) were 331.2 ± 97.6 and 253.4 ± 53.6 μm (Δ = –77.8 ± 104.7 μm, p < 0.001), with CST SD across 24 months of 42.0 ± 32.8 μm. Baseline and 24-month VA
were 58.8 ± 19.2 and 62.4 ± 20.6 Early Treatment of Diabetic Retinopathy Study letters
(Δ = +3.7 ± 20.8 letters, p = 0.008). CST SD over 24 months was a statistically significant negative predictor
of 24-month change in VA (–15.41 [–20.98, –9.83] letters per 100 μm, p < 0.001). Quartile analysis of 24-month VA by CST SD showed a +11.2-letter difference
between the first and last quartiles (p < 0.001). Baseline CST was a predictor of 24-month CST SD (24.88 [22.69, 27.06] μm
per 100 μm, p < 0.001).
Conclusions
Higher macular thickness fluctuations are related to poorer visual outcomes at 24
months in patients with nAMD treated with anti-vascular endothelial growth factor
injections. Macular thickness variability may be an important prognostic factor of
visual outcomes in nAMD eyes.
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Article Info
Publication History
Published online: July 17, 2021
Accepted:
June 11,
2021
Received in revised form:
May 3,
2021
Received:
February 23,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
