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. 2015 Oct 21:15:138.
doi: 10.1186/s12886-015-0123-y.

Intravitreal treatment in patients with exudative age-related macular degeneration and visual acuity ≤ 0.05

Raphael Koch  1 , Matthias Schmidt  2 , Sabine Gebauer  3 , Holger Busse  4 , Constantin E Uhlig  5
Affiliations

Intravitreal treatment in patients with exudative age-related macular degeneration and visual acuity ≤ 0.05

Raphael Koch et al. BMC Ophthalmol. .

Abstract

Background: To investigate intravitreal treatment efficiencies in patients suffering from exudative ARMD with a BCVA ≤ 0.05.

Methods: Retrospective analysis: Analysis parameters were lesion type, BCVA at baseline and at follow-up, the intravitreal drug used, and its application frequency. Patients were divided into: 1) following injections of bevacizumab, triamcinolone, their combination, or ranibizumab regardless of their lesion subtype, 2) or by lesion subtype. Statistical tests were performed using Wilcoxon signed-rank tests, Kruskal-Wallis tests and multivariable logistic regressions.

Results: Seventy four eyes of 74 patients were analyzed. Follow-up was at 12.0 to 15.7 weeks. Median difference of BCVA (logMAR) between baseline and follow-up was 0.000 (-0.030, 0.175) in classic (p = 0.105), 0.000 (-1.15, 0.20) in occult (p = 0.005), -0.200 (-1.20, 0.60) in cases with subretinal fluid (p = 0.207), 0.000 (-0.60, 0.30) in pigment epithelial detachment (p = 0.813), and 0.050 (-0.40, 0.70) in Junius Kuhnt maculopathy (p = 0.344). BCVA increased ≥ 0.2 logMAR in 4 (24 %) classic, 9 (47 %) occult, 6 (33 %) pigment epithelial detachment, 6 (55 %) subretinal fluid, in 29 (39 %) eyes regardless of the lesion type, and reached a BCVA ≥ 0.05 in 7 (9 %) of those with a baseline BCVA <0.05.

Conclusions: Results indicate that in patients with ARMD and a BCVA lower 0.05, intravitreal treatment may improve visual acuity, most probably in cases with occult lesions.

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Figures

Fig. 1
Fig. 1
Development of BCVA in patients with exsudative ARMD and (a) classic subtype, (b) occult subtype, and (c) in cases with subfoveal fluids without subtype differentiation. Grey area defines cases with visual acuity that have increased and exceeded 0.05 decimal acuity (Snellen letters, left side) or gone below 1.3 logMAR (right side) during follow-up. Due to equal values (ties), a random offset was added to these values to enhance visibility
Fig. 2
Fig. 2
Development of BCVA in different ARMD subtypes during follow-up
Fig. 3
Fig. 3
Development of BCVA in patients with exudative ARMD and (a) pigment epithelial detachment, and (b) Junius-Kuhnt maculopathy. Grey area defines cases with visual acuity that have increased and exceeded 0.05 decimal acuity (Snellen letters, left side) or gone below 1.3 logMAR (right side) during follow-up. Due to equal values (ties), a random offset was added to these values to enhance visibility
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