[Association between integrity of foveal photoreceptors and ultimate visual outcome in neovascular age-related macular degeneration].

Abstract

Purpose: This study investigates the clinical features and outcome dimensions of neovascular age-related macular degeneration (nAMD).

Material and methods: This retrospective study analyzed 80 subjects diagnosed with nAMD. The patients received successful treatment through intravitreal administration of anti-vascular endothelial growth factor (anti-VEGF) agents. The subjects were classified into three groups based on the final integrity of their inner segment/outer segment (IS/OS) layer of the retina, assessed using spectral-domain optical coherence tomography (SD-OCT). This classification helped to understand the extent of retinal damage and the progression of nAMD. The primary evaluation was to examine the association between final IS/OS integrity and final visual acuity in the groups. The study also evaluated foveal microstructures (choroidal neovascularization size, external limiting membrane, outer nuclear layer thickness, and central macular thickness) at the initial and final visits, and their relationships with final IS/OS integrity.

Results: The study found a significant association (P<0.001) between final visual acuity and IS/OS integrity. The V group had the best visual acuity (0.12±0.09) compared to the P group (0.39±0.45) and I group (0.92±0.42). Improved visual acuity was strongly correlated with less disrupted IS/OS and ELM. Intact photoreceptor integrity was linked to preserved IS/OS and ELM, thinner CMT, and shorter CNV height before treatment. However, photoreceptor integrity was not significantly correlated with CMT, RPE regularity, or ONL thickness at the final examination, suggesting it may be independently affected by nAMD.

Conclusion: Final visual acuity in nAMD patients post-treatment was strongly linked to foveal photoreceptor integrity. Photoreceptor integrity correlated with initial visual acuity, CMT, ELM integrity, CNV height, and IS/OS layer integrity. These factors can predict visual outcomes after resolution of exudaiton.