Fluorescein angiographic characteristic in predominantly classic and occult types of neovascular age-related macular degeneration treated with ranibizumab

Cemal Çavdarlı; Sebile Çomçalı; Pınar Topcu Yılmaz; Mehmet Numan Alp

doi:10.1177/25158414211005305

Fluorescein angiographic characteristic in predominantly classic and occult types of neovascular age-related macular degeneration treated with ranibizumab

Ther Adv Ophthalmol. 2021 Apr 14:13:25158414211005305. doi: 10.1177/25158414211005305. eCollection 2021 Jan-Dec.

Authors

Cemal Çavdarlı¹, Sebile Çomçalı², Pınar Topcu Yılmaz², Mehmet Numan Alp²

Affiliations

¹ Department of Ophthalmology, Ankara City Hospital, University of Health Sciences, Bilkent, Çankaya, Ankara 06800, Turkey.
² Department of Ophthalmology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.

Abstract

Background and purpose: Randomised-controlled clinical trials (the ANCHOR and MARINA) examined the intravitreal anti-vascular endothelial growth factor (anti-VEGF) efficacy for eyes having fluorescein angiographic classic and occult (OCC) neovascular lesions. No significant difference in the treatment response between the lesion types was observed. Fundus fluorescein angiography and optical coherence tomography (OCT) are complementary devices that provide information about neovascular age-related macular degeneration (n-AMD). The aim of this retrospective study was to compare the clinical aspects of fluorescein angiographic characteristics in predominantly classic (PDC) and OCC subtypes of n-AMD treated with intravitreal ranibizumab.

Methods: Treatment-naive fluorescein angiographic OCC-n-AMD and PDC-n-AMD patients, who received monthly intravitreal ranibizumab for 3 months after baseline, and were followed-up with pro re nata injections between March 2013 and February 2018, were included. Means of the visual acuity (VA), central macular thickness (CMT), and intravitreal injection and visit numbers of the groups were compared throughout 24 months.

Results: We included 41 eyes of PDC-n-AMD patients and 36 eyes of OCC-n-AMD patients. The mean ages were 74.5 ± 10.6 and 71.9 ± 9.4, respectively. The baseline, and 3-, 6-, 12-, 18-, and 24-month VA results of the OCC group were significantly better than those in the PDC. However, VA gain in the PDC group at 3, 6, and 12 months was significantly higher than that in the OCC group. The mean of baseline CMT of the PDC (353 ± 118 µm) was significantly higher than that in the OCC group (293 ± 64 µm). No significant differences in terms of the number of visits or injections, or CMT change from the baseline values between groups were observed.

Conclusion: The OCC-n-AMD patients had better baseline and follow-up VA and CMT means than the PDC-n-AMD patients. However, the PDC-n-AMD patients are expected to benefit more than the OCC-n-AMD patients in terms of VA gains.

Keywords: age-related macular degeneration; classical; fluorescein angiography; neovascular; occult; ranibizumab.