AUTHOR=Türksever Cengiz , Hoffmann Laura , Hatz Katja 

TITLE=Peripapillary and macular microvasculature in neovascular age-related macular degeneration in long-term and recently started anti-VEGF therapy versus healthy controls

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1080052

DOI=10.3389/fmed.2022.1080052

ISSN=2296-858X

ABSTRACT=Aim: To investigate the peripapillary and macular microvasculature in neovascular age-related macular degeneration (nAMD) in recently started versus long-term anti-vascular endothelial growth factor (VEGF) therapy and healthy controls.
Methods: Eyes with nAMD treated in a treat-and-extend regimen were assigned to group 1 (<5 injections) or 2 (≥20 injections) whereas group 3 constituted the healthy age-matched controls. Blood flow signals were acquired using PLEX® Elite 9000 swept-source optical coherence tomography angiography of the macular and peripapillary regions. Mean ganglion cell complex thickness values were quantified using spectral-domain optical coherence tomography.
Results: Including 80 eyes whereof 40 controls, macular superficial perfusion density was significantly reduced in group 1 and 2 compared to controls (p<0.001; p=0.010) without a difference between groups 1 and 2. Peripapillary perfusion parameters did not correlate with postoperative intraocular pressure (IOP) or number of anti-VEGF injections. Mean peripapillary flux index was significantly lower in group 2 than in controls (p=0.023) and significantly decreased in the nasal quadrants for both AMD groups compared to group 3 (p=0.013; p<0.001). Mean peripapillary perfusion density was significantly reduced in both AMD groups compared to controls (0.515 ± 0.02 versus 0.556 ± 0.03, p<0.0001).
Conclusion: Frequency of anti-VEGF treatment in nAMD and postoperative IOP showed no correlation with peripapillary perfusion parameters, but anti-VEGF treated nAMD patients exhibited partly altered peripapillary perfusion compared to healthy controls. Reduced macular perfusion density of the inner retina in anti-VEGF treated nAMD compared to healthy controls might be discussed as an anti-VEGF treatment effect or a characteristic of nAMD.