Relationship between ganglion cell complex thickness and vision in age-related macular degeneration treated with aflibercept

Abstract

Purpose This study aimed to analyze the correlation between ganglion cell complex thickness (GCCT) and vision compared with the choroidal thickness (CT) and central retinal thickness (CRT) in relation to the outcomes of intravitreal aflibercept treatment for choroidal neovascular membranes secondary to age-related macular degeneration (AMD). Methods This was a prospective, observational study. Forty-three eyes of 38 patients with wet AMD received a monthly loading dose of 2 mg aflibercept by intravitreal injection (IVI) during the first 3 months and were then followed at regular monthly intervals for an average of 10 months by a pro re nata regimen. All patients were examined using spectral domain-optic coherence tomography (OCT) and enhanced depth imaging OCT. According to their response to IVI treatment in the third month, patients were divided into 2 groups, both functionally and anatomically. Results Three-month GCCT and optic disc retinal nerve fiber layer thickness (ODRNFLT) had the most correlation with the 10-month vision (p  =  0.002, p  =  0.02, respectively). While baseline GCCT was most correlated with the functional response, baseline CRT was most correlated with the anatomical response (p  =  0.01, p  =  0.004, respectively). Conclusions The results suggest that a reduction in 3-month GCCT indicates a good long-term vision outcome, while a reduction in 3-month ODRNFLT shows a poor long-term vision outcome. The literature suggests that this study is the first to demonstrate that baseline GCCT is more strongly correlated with the functional response than it is with CT and CRT. Hence, GCCT has a prognostic value for vision impairment.