OCT-guided intravitreal injection of VEGF therapy may result in less vision gain

Intravitreal injection therapy with an anti-VEGF agent that is guided by optical coherence tomography may under-treat patients and result in less visual gain, according to a study.

In a population of 131 treatment-naïve eyes of 124 patients with wet age-related macular degeneration treated with Lucentis (ranibizumab, Genentech) on an as-needed basis guided by clinical examination and OCT imaging, visual improvement correlated with the number of injections delivered but not to resolution of fluid.

At baseline, the mean visual acuity for the group was 20/110, which improved at 6 months to 20/80. At last follow-up, mean visual acuity was 20/90. Also, at 6 months, 31% of eyes had gained three lines of visual acuity and 90.5% had avoided a loss of three lines.

However, eyes that received injections at an interval less than 2 months gained more vision than eyes that received injections with a greater interval. Eyes receiving injections with less than 2 months mean inter-injection interval gained 2.3 lines at 6 months compared with 0.46 lines gained among eyes with less frequent injections. Only 3.1% of patients in the more frequent injection group lost three or more lines of vision compared with 15.9% in the less frequent injection group.

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