PMID- 19875667
OWN - NLM
STAT- MEDLINE
DCOM- 20100326
LR  - 20151119
IS  - 1552-5783 (Electronic)
IS  - 0146-0404 (Linking)
VI  - 51
IP  - 3
DP  - 2010 Mar
TI  - Effects on choroidal neovascularization after anti-VEGF Upload using intravitreal 
      ranibizumab, as determined by spectral domain-optical coherence tomography.
PG  - 1671-6
LID - 10.1167/iovs.09-4496 [doi]
AB  - PURPOSE: It is unclear whether anti-VEGF monotherapy in age-related macular 
      degeneration (AMD) achieves morphologic CNV regression or only stops further CNV 
      growth. In this study, spectral domain-optical coherence tomography (SD-OCT) was 
      used to image CNV structure before and after anti-VEGF treatment. METHODS: Out of 
      107 consecutive patients, a prospective CNV evaluation was possible in 78 of 
      them. Newly diagnosed CNV (classic CNV: n = 16; occult CNV: n = 54; minimal 
      classic CNV: n = 8) due to AMD was imaged before and 4 weeks after anti-VEGF 
      upload in three intravitreal injections of ranibizumab. Qualitative (structural 
      changes) and quantitative measurements (diameter and thickness) of the CNV were 
      obtained from the OCT images. RESULTS: Classic CNV components were observed above 
      the RPE/photoreceptor complex, whereas occult CNVs stayed below. Of all 
      postoperative OCTs, 59% revealed complete dry retinal structures, 27% showed 
      reduced edema, and 14% showed edema remaining unchanged. Mean macular thickness 
      decreased significantly from 427 to 303 microm (P = 0.000). Qualitatively, 
      overall CNV architecture appeared to be unchanged in 78%, was reduced in 
      thickness in 18%, and became larger in 4%. Quantitatively, in all CNV subtypes, 
      the diameter of the CNV lesions (preoperative, 2813 microm; postoperative, 2804 
      microm) did not change after treatment (classic CNV: P = 0.390; occult CNV: P = 
      0.405, minimal classic CNV: P = 0.092) independent of postoperative retinal 
      edema. The overall thickness of the lesion, however, was reduced from 205 to 175 
      microm (P = 0.000). Thickness reduction was significantly enhanced especially in 
      CNV with classic components (n = 24; 252 to 197 microm; P = 0.000; reduction, 
      22%), whereas reduction was smaller but also significant in occult CNV (183 to 
      164 microm; P = 0.003; reduction, 10%). CONCLUSIONS: With SD-OCT, CNV size can be 
      two-dimensionally determined and followed up after intravitreal anti-VEGF 
      treatment. In only 4% of CNV was enlargement observed, whereas in 78%, CNV 
      architecture appeared qualitatively unchanged, independent of retinal edema. 
      Quantitative measurements underlined stable CNV diameters for all subtypes but 
      revealed significant reduction of thickness especially for classic CNV 
      components. In this series, ranibizumab monotherapy was able to morphologically 
      stop further CNV growth but, in most patients, did not lead to a major regression 
      of CNV, especially of its occult components.
FAU - Framme, Carsten
AU  - Framme C
AD  - University Eye Hospital, Regensburg, Germany. carsten.framme@insel.ch
FAU - Panagakis, Georgios
AU  - Panagakis G
FAU - Birngruber, Reginald
AU  - Birngruber R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20091029
PL  - United States
TA  - Invest Ophthalmol Vis Sci
JT  - Investigative ophthalmology & visual science
JID - 7703701
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - ZL1R02VT79 (Ranibizumab)
SB  - IM
MH  - Angiogenesis Inhibitors/*administration & dosage
MH  - Antibodies, Monoclonal/*administration & dosage
MH  - Antibodies, Monoclonal, Humanized
MH  - Choroidal Neovascularization/*diagnosis/*drug therapy
MH  - Fluorescein Angiography
MH  - Humans
MH  - Injections
MH  - Prospective Studies
MH  - Ranibizumab
MH  - *Tomography, Optical Coherence
MH  - Vascular Endothelial Growth Factor A/*antagonists & inhibitors
MH  - Vitreous Body
EDAT- 2009/10/31 06:00
MHDA- 2010/03/27 06:00
CRDT- 2009/10/31 06:00
PHST- 2009/10/31 06:00 [entrez]
PHST- 2009/10/31 06:00 [pubmed]
PHST- 2010/03/27 06:00 [medline]
AID - iovs.09-4496 [pii]
AID - 10.1167/iovs.09-4496 [doi]
PST - ppublish
SO  - Invest Ophthalmol Vis Sci. 2010 Mar;51(3):1671-6. doi: 10.1167/iovs.09-4496. Epub 
      2009 Oct 29.