Abstract

P 272

Central autofluorescence (AF) as prognostic factor for anti-VEGF therapy: morphological correlations

Jan Christian Goebel, Britta Elisabeth Heimes, Matthias Gutfleisch, Georg Spital, Albrecht Lommatzsch, Daniel Pauleikhoff
Augenabteilung am St. Franziskus-Hospital, Münster

Objective
In former studies the initial central autofluorescence (AF) could be characterized as the most significant factor for the course of visual acuity after anti-VEGF therapy in exsudative AMD. To describe the morphological fundamentals on the level of RPE and/or retina for this changed central pattern, correlations of the AF-analysis with the Spectralis-results were performed.
Methods
In 30 patients with an exsudative AMD and the minimal criterium of an occult CNV with confirmed disease progression the central pattern of AF was assessed as normal or changed. Apart from this the visual acuity was obtained. Also morphological values in Spectralis-OCT like CNV-thickness, PED-hight, retinal thickness, hight and dimension of intra- and subretinal fluid, changes in RPE were determined. All results were elevated and analyzed before first and 4 weeks after third intravitreal anti-VEGF-application. A statistical interpretation with analysis of correlations followed.
Results
Once again the integrity of foveolar AF is the most significant factor in relation to the course of visual acuity (p<0.01). Both, changes in RPE (in terms of RPE-proliferations) and intraretinal fluid (mostly cysts), correlate with the characteristic of a changed central AF (p<0.05). On the other hand factors like CNV-thickness, PED-hight, subretinal fluid and retinal thickness do not correlate with these changes in the initial central AF.
Conclusions
A changed foveolar AF is the most important prognostic factor for an eventual increase of visual acuity after anti-VEGF-therapy. This could primary be the effect of a combination of initial RPE- and intraretinal changes and damaging. These results support the hypothesis, that dimension of initial morphological und functional damages of foveolar RPE and retina (especially intraretinal lesions) are the central parameter for the course of visual acuity after anti-VEGF-therapy. To find a closer definition of these, is therefore of central importance.

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