GOOD VISUAL OUTCOME AT 1 YEAR IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION WITH PIGMENT EPITHELIUM DETACHMENT Factors Influencing the Treatment Response

Purpose: To evaluate baseline and treatment factors influencing the response of pigment epithelial detachment (PED) in patients with treatment-naive neovascular agerelated macular degeneration after 1 year of intravitreal anti-vascular endothelial growth factor treatment. Methods: This retrospective consecutive case series study included 104 eyes (94 patients) with treatment-naive neovascular age-related macular degeneration and associated PED >150 mu m treated with aflibercept (n = 41) or ranibizumab (n = 63) for at least 1 year. Stepwise linear regression was used to assess factors influencing best-corrected visual acuity and PED response. Results: At 1 year, the best-corrected visual acuity improved from 20/63(+1) (60.8 +/- 15.9 Early Treatment of Diabetic Retinopathy Study letters) at baseline to 20/40(-1) (69.0 +/- 15.0 letters) (P = 0.001), and PED maximal height decreased from 370.8 +/- 205.6 mu m to 238.8 +/- 178.5 mu m (P = 0.001). Multivariate analysis revealed an association of the visual improvement with lower best-corrected visual acuity at baseline (P = 0.001), the presence of foveal subretinal fluid (P = 0.001), and female gender (P = 0.047). Pigment epithelial detachment height reduction was dependent on higher baseline PED height (P = 0.001) and treatment drug (P = 0.008). Conclusion: Visual improvement in neovascular age-related macular degeneration with PED was equally achieved with ranibizumab and aflibercept, influenced mainly by baseline best-corrected visual acuity and foveal subretinal fluid. Pigment epithelial detachment height reduction was influenced by baseline height and the treatment drug, favoring aflibercept for a stronger effect. The clinical significance of this result warrants further studies.