丸子 一朗
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Macular atrophy after aflibercept therapy for neovascular age-related macular degeneration: outcomes of Japanese multicenter study.
Journal Formal name:Japanese journal of ophthalmology
Abbreviation:Jpn J Ophthalmol
ISSN code:16132246/00215155
Domestic / ForeginDomestic
Volume, Issue, Page 64(4),pp.338-345
Author and coauthor Koizumi Hideki, Yamamoto Akiko, Ogasawara Masashi, Maruko Ichiro, Hasegawa Taiji, Itagaki Kanako, Sekiryu Tetsuju, Okada Annabelle A, Iida Tomohiro
Publication date 2020/07
Summary PURPOSE:To evaluate the development and rate of growth in macular atrophy after intravitreal injections of aflibercept (IVAs) for neovascular age-related macular degeneration (AMD) over a 2-year period.STUDY DESIGN:Retrospective, interventional, consecutive case series.METHODS:This study included 94 eyes of 92 patients with treatment-naïve AMD involving the foveal center treated with IVAs at 3 university hospitals in Japan. The patients underwent IVAs bimonthly after 3 initial monthly doses in the first year. The protocol was converted to a treat-and-extend regimen in the second year. The incidence and growth rate of macular atrophy were quantified based on hypoautofluorescence detected by fundus autofluorescence images. Additionally, possible background factors related to the development and rate of growth of macular atrophy were investigated.RESULTS:Of 94 eyes, 39 (41.5%) had typical AMD and 55 (58.5%) had polypoidal choroidal vasculopathy. Ten eyes (10.6%) had macular atrophy at the baseline. Of the remaining 84 eyes, 14 (16.7%) had developed new macular atrophy at 2 years, the square root of the growth rate of atrophy was 0.52 mm/year. In multivariate analyses, a poorer best-corrected visual acuity (P = 0.01) and the presence of intraretinal fluid (P = 0.04) at baseline were found to be the independent predictors for the development of macular atrophy. No factors were found that were significantly related to the growth rate of the macular atrophy.CONCLUSIONS:Our study determined the incidence and rate of growth of macular atrophy after IVAs for neovascular AMD in clinical settings. Eyes with vision reduction and intraretinal fluid at the baseline develop macular atrophy more frequently after IVAs for neovascular AMD.
DOI 10.1007/s10384-020-00745-0
PMID 32447586