Effect of Intravitreous Anti–Vascular Endothelial Growth Factor Therapy on Choroidal Thickness in Neovascular Age-Related Macular Degeneration Using Spectral-Domain Optical Coherence Tomography

A critical method of monitoring patients with neovascular age-related macular degeneration (AMD) being treated with anti-vascular endothelial growth factor (anti-VEGF) is optical coherence tomography (OCT), which uses low-coherence interferometry of light to examine the retina in vivo on a micrometer scale. 1 Recent advances in spectral-domain OCT make visualization of the choroid feasible.Using image averaging and enhanced depth imaging, successful examination and measurement of choroidal thickness in normal and pathologic states have been reported.[2][3][4] It has been hypothesized that anti-VEGF may affect choroidal vasculature.5 The goal of this study is to evaluate the effect of anti-VEGF on choroidal thickness using spectral-domain OCT in treatment-naive subjects. MethodsTwenty-two patients (22 eyes) with neovascular AMD were identified prior to first-time treatment with anti-VEGF at New England Eye Center.All patients with concomitant ocular pathologies were excluded.Twenty age-matched healthy eyes were identified as a control group.This study was approved by the institutional review board of the Tufts Medical Center.Patients were imaged with spectral-domain OCT prior to first-time treatment with anti-VEGF therapy and again at 3, 6, and 12 months (Figure 1).Control eyes were imaged at the time of identification and 6 months later.The scan pattern used was Cirrus high-definition 1line raster (Carl Zeiss Meditec), which is a 6-mm line consisting of 4096 A-scans and 20 Bscans averaged together without tracking.