Subfoveal Choroidal Thickness as a Potential Predictor of Visual Outcome and Treatment Response After Intravitreal Ranibizumab Injections for Typical Exudative Age-Related Macular Degeneration

PURPOSE: To investigate the prognostic implication of subfoveal choroidal thickness on treatment outcome after intravitreal ranibizumab injections for typical exudative age-related macular degeneration (AMD). DESIGN: Retrospective study. METHODS: A total of 40 eyes of 37 patients who completed 6-month follow-up were analyzed. Patients' data were retrieved from medical records including best-corrected visual acuity (BCVA). Subfoveal choroidal thickness at baseline, 3 months, and 6 months was measured by enhanced depth imaging optical coherence tomography and adjusted for age and sex before statistical analysis. Treatment response was after 3 monthly intravitreal ranibizumab injections. Responders (responder group) were defined as a 100 mu m or more decrease or complete resolution of subretinal fluid, whereas nonresponders (nonresponder group) were defined as changes less than 100 mu m or more than 100 pm increase of subretinal fluid by optical coherence tomography. RESULTS: Mean age at diagnosis was 72.1 +/- 8.1 years, and 22 eyes (55.0%) were responders. The responder group had thicker subfoveal choroid (257.2 +/- 108.3 mu m) and smaller lesions (1.3 +/- 0.8 mu m) at baseline than the nonresponder group (167.1 +/- 62.4 mu m, P = .003; and 2.0 +/- 1.0 mu m, P = .008). The responder group showed significantly better BCVA and thicker subfoveal choroid than the nonresponder group at 3 months (P = .002 and P = .023) and 6 months (P = .004 and P = .031). Stepwise and binary regression analysis demonstrated that subfoveal choroidal thickness was significantly correlated with visual outcome (B = -0.002, P = .003) and treatment response (B = 8.136, P = .018). CONCLUSION: Subfoveal choroidal thickness may be a predictive factor for visual outcome and treatment response in typical exudative AMD after intravitreal ranibizumab injections. (C) 2014 by Elsevier Inc. All rights reserved.