Journal
OPHTHALMOLOGY RETINA
Volume 5, Issue 12, Pages 1204-1213Publisher
ELSEVIER INC
DOI: 10.1016/j.oret.2021.02.012
Keywords
Ellipsoid zone; subretinal hyperreflective material; sub-retinal pigment epithelium; neovascular age-related macular degeneration; OCT
Categories
Funding
- Novartis Pharmaceuticals, East Hanover, New Jersey
- National Eye Institute, National Institutes of Health, Bethesda, Maryland [K23-EY022947-01A1, R34-EY029308]
- Tom and Maryanne Wagner Advanced Imaging Research Fund
- Betty Powers Optical Coherence Tomography Research Fund
- Norman C. and Donna L. Harbert Endowed Chair Fund
- Tony and Leona Campane Image-Guided Surgery and Advanced Image Analysis Research Fund
- Novartis Pharmaceuticals
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The study found that anti-VEGF treatment can improve EZ integrity, SHRM, and sub-RPE features in eyes with nAMD. EZ integrity and SHRM volume were predictors of visual acuity.
Purpose: To assess longitudinally the effect of anti-vascular endothelial growth factor (VEGF) treatment on ellipsoid zone (EZ) integrity, subretinal hyperreflective material (SHRM), and the sub-retinal pigment epithelium (sub-RPE) compartment in eyes with neovascular age-related macular degeneration (nAMD). Design: Post hoc analysis of the OSPREY clinical trial, a prospective, double-masked, phase 2 study comparing brolucizumab 6 mg with aflibercept 2 mg over 56 weeks. Participants: Participants with treatment-naive nAMD at the initiation of the trial were included in the analysis. Methods: Eyes were evaluated with spectral-domain OCT at 4-week intervals in the OSPREY trial (n = 81). Spectral-domain OCT scans collected from each visit were segmented automatically using a proprietary, machine learning-enabled higher-order feature-extraction platform for retinal layer, SHRM, and sub-RPE boundary lines, which were evaluated and corrected as needed by masked trained graders. The current analysis focused only on patients evaluated with the Cirrus (Zeiss) platform (n = 28). Main Outcome Measures: Outcome measures included change from baseline in EZ-RPE (i.e., photoreceptor outer segment) volume, EZ-RPE central subfield thickness (CST), total EZ attenuation, SHRM volume, SHRM CST, and total sub-RPE volume. The correlation between each of these measures and best-corrected visual acuity (BCVA) at each visit was evaluated. Results: EZ-RPE volume and EZ-RPE CST showed significant increases, and total EZ attenuation, SHRM volume, SHRM CST, and total sub-RPE volume showed significant decreases from baseline at each visit from weeks 4 through 56 (P < 0.05 at each visit). Ellipsoid zone integrity measures and SHRM volume correlated significantly with BCVA at most visits (P < 0.05). No significant correlation was found between total sub-RPE volume and BCVA. Conclusions: EZ integrity, SHRM, and sub-RPE disease features in eyes with nAMD showed improvement as early as week 4 of anti-VEGF treatment. EZ integrity measures and SHRM volume were predictors of visual acuity over the first year of treatment. (C) 2021 by the American Academy of Ophthalmology.
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