PIGMENT EPITHELIAL DETACHMENT THICKNESS AND VARIABILITY AFFECTS VISUAL OUTCOMES IN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

Author:

Sarraf David1,Khanani Arshad M.23,Sadda SriniVas R.4,Chang Andrew5,Wong David T.6,Kempf Anne-Sophie7,Saffar Insaf7,Tang Shuhan7,Tadayoni Ramin89

Affiliation:

1. Stein Eye Institute, University of California, Los Angeles, Los Angeles, California;

2. Sierra Eye Associates, Reno, Nevada;

3. Reno School of Medicine, University of Nevada, Reno, Nevada;

4. Doheny Eye Institute, University of California, Los Angeles, Los Angeles, California;

5. Sydney Retina Clinic, Sydney Eye Hospital, Sydney University, Camperdown, NSW, Australia;

6. Unity Health Toronto-St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada;

7. Novartis Pharma AG, Basel, Switzerland;

8. Department of Ophthalmology, Université Paris Cité, AP-HP, Lariboisière, Saint Louis, Missouri;

9. Rothschild Foundation Hospitals, Paris, France.

Abstract

Purpose: To evaluate the impact of pigment epithelial detachment (PED) thickness (i.e., height) and thickness variability on best-corrected visual acuity outcomes in patients with neovascular age-related macular degeneration in the Phase 3 HAWK and HARRIER trials. Methods: Optical coherence tomography images from the pooled brolucizumab 6 mg and aflibercept 2 mg arms were analyzed for the maximum PED thickness across the macula at baseline through to week 96. Best-corrected visual acuity outcomes were compared in patients with different PED thickness and variability cut-off thresholds. Results: Greater PED thickness at baseline or at week 12 was associated with lower mean best-corrected visual acuity gain from baseline to week 96 (baseline PED ≥200 µm: +4.6 letters; <200 µm: +7.0 letters; week 12 PED ≥100 µm: +5.6 letters; <100 µm: +6.6 letters). Eyes with the largest PED thickness variability from week 12 through week 96 gained fewer letters from baseline at week 96 (≥33 µm: +3.3 letters; <9 µm: +6.2 letters). Furthermore, increased PED thickness at week 48 was associated with higher prevalence of intraretinal and subretinal fluid. Conclusion: In this treatment-agnostic analysis, greater PED thickness and PED thickness variability were associated with poorer visual outcomes in patients with neovascular age-related macular degeneration and greater neovascular activity.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Ophthalmology,General Medicine

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