TYPE 1 VERSUS TYPE 3 NEOVASCULARIZATION IN PIGMENT EPITHELIAL DETACHMENTS ASSOCIATED WITH AGE-RELATED MACULAR DEGENERATION AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY: A Prospective Study.

Retina

*Department of Ophthalmology, David Geffen School of Medicine, Stein Eye Institute, University of California Los Angeles, Los Angeles, California; †Department of Ophthalmology, David Geffen School of Medicine, Doheny Eye Institute, University of California Los Angeles, Los Angeles, California; ‡Southern California Desert Retina Consultants, Palm Desert, California; §Department of Ophthalmology, Loma Linda University Eye Institute, Loma Linda, California; ¶Black Hills Regional Eye Institute, Rapid City, South Dakota; and **Department of Ophthalmology, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA.

Published: December 2016

AI Article Synopsis

  • The study aimed to evaluate the effectiveness of aflibercept therapy in treating Type 1 and Type 3 neovascularization associated with age-related macular degeneration.
  • Results showed that Type 3 lesions had a significantly greater improvement in vision and required fewer injections than Type 1 lesions over a 12-month period.
  • The findings suggest that understanding the neovascularization subtype at diagnosis could lead to more personalized and effective treatment strategies.

Article Abstract

Purpose: To evaluate the response to aflibercept therapy for Type 1 and Type 3 neovascularization in pigment epithelial detachments associated with treatment-naive, neovascular age-related macular degeneration.

Methods: In this multicentered, prospective study, eligible eyes underwent an intravitreal aflibercept injection protocol for 12 months. Visual acuity and morphologic features of the pigment epithelial detachments were compared at baseline and follow-up intervals between eyes with Type 1 versus Type 3 neovascularization.

Results: Thirty-six eyes were analyzed. At 12 months, Type 1 lesions showed a 4.5 ± 23 Early Treatment of Diabetic Retinopathy Study letter improvement (P = 0.1665) versus a 14 ± 11 (P = 0.0072) letter improvement with Type 3 lesions. Both Type 1 and 3 eyes showed a significant decrease in pigment epithelial detachment size, subretinal fluid, and subretinal hyperreflective material; however, Type 3 eyes had a greater reduction in pigment epithelial detachment size and subretinal hyperreflective material, as well as a reduction in central retinal thickness. Type 1 eyes required an average of 1.636 (range, 1-4) injections to resolve fluid, which was greater than Type 3 eyes, which required an average of 1.143 (range, 1-2) injections (P = 0.0251).

Conclusion: Intravitreal aflibercept injections were efficacious for pigment epithelial detachments, but baseline and follow-up anatomical and functional outcomes differed in Type 1 versus Type 3 neovascularization. The better response of Type 3 eyes with fewer injections suggests that differentiation of the neovascularization subtype at the initial diagnosis may allow for a more tailored, optimal therapy.

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Source
http://dx.doi.org/10.1097/IAE.0000000000001271DOI Listing

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