Prognostic Value of Retinal Pigment Epithelium Elevation in Anatomical Success After Loading Phase in Neovascular Age-Related Macular Degeneration Treated with Bevacizumab

Abstract

Purpose: To determine the value of retinal pigment epithelium (RPE) elevation area and volume in the prognosis of neovascular age related macular degeneration (nAMD). Materials and Methods: Twenty-five eyes of 25 treatment naive nAMD patients (13 male,12 female) were included in this retrospective study. AMD cases with classical choroidal neovascularization (CNV) demonstrated by fundus flourescein angiography were included in the study. Two groups were divided according to the presence of subretinal fluid (SRF) (group 1) and absence of SRF (group 2) at the first visit after 3 months of anti-VEGF (Bevacizumab) loading. Best corrected visual acuity (BCVA), intraocular pressure values, center macular thickness (CMT), SRF height, center 3 and 5 mm RPE elevation area and volume were evaluated. Results: There were 13 patients in group 1 and there was no difference in age and gender between the groups. There was no significant correlation between the delta value of RPE elevation areas and volumes before and after treatment and the change in BCVA values. According to the results obtained from the Univariate risk analysis, CMT, RPE elevation area 3mm, RPE elevation area 5mm and RPE elevation volume 3mm (p:0.028, p:0.002, p:0.044, and p:0.059, respectively) were included in the logistic regression analysis model. In logistic regression analysis, it was observed that baseline RPE elevation area 3mm was significantly associated with the presence of subretinal fluid after the loading phase (OR:6.062, CI:1.173-31.335, p:0.032). Conclusion: The RPE elevation area at the central 3 mm at the first presentation may have value as a marker in determining the prognosis of nAMD.