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  • Subretinal pigment epithelium fibrotic tissue morphological changes after a single anti-vascular endothelial growth factor injection in age-related macular degeneration

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Clinical science
Subretinal pigment epithelium fibrotic tissue morphological changes after a single anti-vascular endothelial growth factor injection in age-related macular degeneration
  1. Avi Ohayon1,
  2. Irene De Rosa1,
  3. Oudy Semoun1,
  4. Camille Jung1,2,
  5. Donato Colantuono1,
  6. Ala'a El Ameen1,
  7. Mayer Srour1,
  8. Eric H Souied1
  1. 1 Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Creteil, France
  2. 2 Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Creteil, France
  1. Correspondence to Dr Avi Ohayon, Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Creteil 94000, France; aviohayonmd{at}gmail.com

Abstract

Aims To demonstrate and evaluate the morphological changes of multilayered fibrovascular pigment epithelial detachment (PED) to a single anti-vascular endothelial growth factor (VEGF) injection in age-related macular degeneration (AMD).

Methods We retrospectively analysed the morphological changes of 30 eyes with exudative AMD showing fibrotic multilayered PED, between two consecutive visits. All patients had one anti-VEGF intravitreal injection at the first visit. We quantitatively analysed the different compartments within the PED and their morphological response.

Results The mean follow-up time interval between the first and the second visit was 32.46±4.64 days. We defined three optical coherence tomography zones within the PED: a subretinal pigment epithelium inhomogeneous hyporeflective space (layer 1), a hyper-reflective band beneath layer 1 (layer 2), and a hyporeflective space between the Bruch’s membrane and layer 2 (layer 3). The mean height of layer 1 was 142±44.63 and 99.30±39.79 µm at visits 1 and 2, respectively. The mean thickness of layer 2 was 101.42±46.66 and 82.76±35.24 µm at visits 1 and 2, respectively. The mean height of layer 3 was 35.77±32.77 and 5.66±8.68 µm at visits 1 and 2, respectively (p=0.009). The mean height change for layer 1 was statistically significantly higher than for layer 2 (p=0.0002).

Conclusions Fibrovascular PED was compartmented into three layers with different reflectivities that morphologically responded differently to a single anti-VEGF injection. Layer 2 had a statistically significantly lower response compared with layer 1, suggesting the hypothesis of a fibrotic component in layer 2.

  • macula
  • retina
  • degeneration

https://doi.org/10.1136/bjophthalmol-2019-314923

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    Footnotes

    • Contributors Design and conduct of the study: AO, OS and EHS; collection, management and analysis: AO, IDR, OS, CJ, DC, AEA and MS; interpretation of the data: AO, OS, CJ and EHS; and preparation, review or approval of the study: AO, OS and EHS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This retrospective study was performed in accordance with the Declaration of Helsinki and current French legislation and with the approval of our local ethics committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.