Unstable retinal thickening may lead to poor visual outcomes during anti-VEGF therapy
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NEW YORK — Unstable retinal thickening may contribute to substandard visual outcomes during anti-VEGF treatment, according to a speaker here.
“As we are all aware, apart from the inconsistency of retinal fluid, variability in foveal thickness during anti-VEGF treatment is associated with worse visual outcomes,” Yodpong Chantarasorn, MD, said at the American Society of Retina Specialists annual meeting.
Chantarasorn and colleagues conducted a retrospective cohort study at five tertiary hospitals between January 2016 and December 2018 to determine predictive biomarkers associated with central subfield thickness fluctuation. A novel parameter, the fluid fluctuation index, was used to assess central subfield thickness variations in clinical practice.
In the 558 eyes analyzed, bevacizumab, aflibercept and ranibizumab accounted for 78.5%, 17.1% and 4.3% of anti-VEGFs used, respectively. Polypoidal choroidal vasculopathy occurred in 58% of the eyes, and 22.7% of eyes were lost to follow-up at 24 months.
Patients with greater fluid fluctuation showed worse best corrected visual acuity than patients with lower fluctuations, with an average difference of 10.7 letters at 12 months and 14 letters at 24 months (both P = .001).
The fluid fluctuation index offers an indirect and simple way to assess choroidal neovascularization activity and individualized responses to anti-VEGF medications, Chantarasorn said.
“Sufficient anti-VEGF therapy may be required in eyes at risk of retinal fluid fluctuation,” he said.
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Chantarasorn Y, et al. Treatment outcome of wet age-related macular degeneration management in Thailand: The study report no. 2: The analysis of retinal fluid fluctuation. Presented at: American Society of Retina Specialists annual meeting; July 13-16, 2022; New York.
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