gms | German Medical Science

Purpose: To evaluate long-term changes in subfoveal choroidal thickness (SFCT) after anti-vascular endothelial growth factor (VEGF) treatment for neovascular age-related macular degeneration (AMD), depending on the type of macular neovascularisation (MNV): MNV type 1 (within the sub-RPE space) and MNV type 2 (within the subretinal space).

Methods: This retrospective study included 101 eyes from 83 patients with MNV type 1 or 2 who received anti-VEGF therapy over a 60-month period. All eyes were treated initially with intravitreal bevacizumab. In case of non-response to bevacizumab, treatment was switched to other agents. SFCT was measured at baseline as well as 6, 12, 24, 36, 48 and 60 months after treatment.

Results: Of the 101 eyes, 62 eyes had MNV-1 (group 1) and 39 eyes had MNV-2 (group 2). There were no significant differences between the study groups regarding patients’ age (80±10 vs. 82±9 years, p=0.2) and the number of injections per eye over a period of 60 months (33.5±11 vs. 29±14, p=0.2). In group 1 (MNV-1), SFCT (µm) changed from 198±53 before treatment to 196±56 after 6 months (p=0.31), to 192±59 after 12 months (p=0.06), to 199±60 after 24 months (p=0.82), to 186±58 after 36 months (p=0.01), to 179±55 after 48 months (p=0.001) and to 172±49 after 60 months (p=0.001). In group 2 (MNV-2), SFCT (µm) changed from 191±45 before treatment to 191±54 after 6 months (p=0.88), to 200±61 after 12 months (p=0.11), to 193±60 after 24 months (p=0.71), to 192±59 after 36 months (p=0.72), to 196±68 after 48 months (p=0.80), and to 186±57 after 60 months (p=0.70).

Conclusion: Despite a comparable number of anti-VEGF injections, a significant long-term reduction in subfoveal choroidal thickness was found only in eyes with MNV type 1, as opposed to eyes with MNV type 2. These results might suggest that choroidal thickness changes in eyes with MNV type 1 may be more sensitive to anti-VEGF treatment compared to eyes with MNV type 2.