Fluctuations in Central Subfield Thickness Limit Effects of Anti-VEGF Therapy

Retinal photo of choroidal neovascularization (CNV). CNV is an abnormal formation of new blood vessels under the retina,typically seen in patients with diabetic retinopathy, block ages of the central retinal vein, and macular degeneration.
Researchers found Central Subfield Thickness fluctuations were associated with lower visual acuity gains during a 52-week study.

The following article is a part of conference coverage from the American Academy of Ophthalmology 2020, being held virtually from November 13 to 15, 2020. The team at Ophthalmology Advisor will be reporting on the latest news and research conducted by leading experts in ophthalmology. Check back for more from the AAO 2020.

In eyes with neovascular age-related macular degeneration (nAMD), the central subfield thickness (CST) can affect the patient’s best-corrected visual acuity (BCVA) after a year of anti-vascular endothelial growth factor (VEGF) treatment, according to research presented at the American Academy of Ophthalmology 2020 meeting. 

The findings, presented by Peter K. Kaiser, MD, included data from the VEGF Trap-Eye: Investigation of Efficacy and Safety in Wet AMD (VIEW) study.

Study participants were monitored for 52 weeks. They received 1 of 3 anti-VEGF regimens; ranibizumab 0.5 mg every 4 weeks (Rq4), or aflibercept 2 mg every 4 weeks (2q4), or aflibercept every 8 weeks (after 3 monthly doses 2q8). From baseline to week 52, subjects’ CST was measured for variability and grouped into quartiles of 448 subjects each: quartile 1 (Q1) at less than or equal to 27.6 μm, quartile 2 (Q2) from 27.6 µm to42.5 μm, quartile 3 (Q3) at 42.5 µm to 65.3 μm, and quartile 4 (Q4) at greater than 65.3 μm. 

From baseline, mean BCVA gains with anti-VEGF groups Rq4, 2q4, and 2q8 were assessed. Within Q1, patients saw improvements of  7.0 letters, 10.3 letters, and 10.1 letters, respectively. In Q2 it was 11.5, 9.3, and 8.8 letters, respectively. For the patients in Q3 it was 10.1, 9.2, and 9.8 letters, respectively. And Q4 saw improvements of 7.4, 8.3, and 6.3 letters, respectively.

The study concludes that greater CST fluctuation was associated with less improvement in BCVA. Further, a similar pattern of gain in acuity with each regimen appeared in every quartile, according to the study.

Disclosure: Peter K. Kaiser, MD has declared affiliations with organizations including biotechnology firms, laboratories, and pharmaceutical companies. Please see the original reference for a full list of the author’s disclosures.

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Kaiser PK. Visual impact of fluctuations in CST in nAMD patients treated with anti-VEGF in VIEW. Presented at: American Academy of Ophthalmology 2020 Annual Meeting; November 13-15, 2020. Abstract PO423.