A real-world study assessing the impact of retinal fluid on visual acuity outcomes in patients with neovascular age-related macular degeneration in Korea

Kim, Jae Hui; Sagong, Min; Woo, Se Joon; Kim, Yu Cheol; Cho, Heeyoon; Lee, Young Ho; Byon, Ik Soo; Jo, Yeonhwa; Chin, Hee Seung; Lee, Youkyung; Chae, Jae Eun; Kang, Se Woong

doi:10.1038/s41598-022-18158-z

Cited by 8 publications

(4 citation statements)

References 44 publications

(49 reference statements)

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“…In a recent cohort-based study conducted between January 2017 and March 2019 (N = 600) in South Korea, the rate of PRN use was 43.8% in the first year and 45.0% in the second year. 17 The inclusion criteria of our study were similar to those of this cohort study; the timepoint of OCTA acquisition (baseline) was 1 year after the initial treatment, and the final timepoint of our study was another year from the time of OCTA acquisition (baseline). Furthermore, PRN patients were more readily available than T&E patients at the initiation of this study, when the patients with AMD who would eventually complete the study were screened and OCTA images were gathered.…”

Section: Discussionmentioning

confidence: 99%

Quantified Anastomotic Areas of Neovascularization as Factors Associated With Frequent Recurrence in Neovascular Age-Related Macular Degeneration

Lee¹,

Kim²,

Kim³

et al. 2023

Retina

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To investigate the quantitative characteristics of anastomoses of macular neovascularization (MNV) in neovascular age-related macular degeneration using optical coherence tomography angiography according to the frequency of intravitreal injections.Methods: Eighty-six eyes of 86 patients treated for neovascular age-related macular degeneration were classified into two groups based on the number of intravitreal injections administered over 12 months: stable (,3) and unstable ($3). Anastomotic areas were defined as areas surrounded by neighboring vessels in the MNV; their total number, mean area, maximal and minimal diameters (i.e., maximal and minimum Feret diameters), and ratio (Feret aspect ratio) were analyzed in the inner and outer areas of the MNV.Results: Forty-four and 42 eyes were classified into the stable and unstable groups, respectively. The eyes in the unstable group had larger anastomotic areas with longer minimum Feret diameters and longer perimeters in the outer MNV. In the logistic regression analysis, instability was associated with a larger anastomotic area and a longer minimum Feret diameter in the outer MNV. Multivariate analysis revealed that a longer minimum Feret diameter in the outer MNV was the most significant factor (P = 0.03). Conclusion:The quantitative characteristics of the anastomotic areas in the MNV might indicate the need for intravitreal injections in patients with neovascular age-related macular degeneration.

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Section: Discussionmentioning

confidence: 99%

Quantified Anastomotic Areas of Neovascularization as Factors Associated With Frequent Recurrence in Neovascular Age-Related Macular Degeneration

Lee¹,

Kim²,

Kim³

et al. 2023

Retina

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“…The selection of an anti-VEGF agent is one of the key early steps in the treatment of neovascular AMD. One of the important www.nature.com/scientificreports/ factors predictive of long-term treatment outcomes is the fluid status after initial loading injections [25][26][27] . More specifically, patients exhibiting retinal fluid after initial loading injection were more likely to show poor longterm visual outcomes 25,27 and required more intensive long-term injections 26 than those not exhibiting.…”

Section: Importance Of Predicting the Difference In Post-treatment Oc...mentioning

confidence: 99%

“…One of the important www.nature.com/scientificreports/ factors predictive of long-term treatment outcomes is the fluid status after initial loading injections [25][26][27] . More specifically, patients exhibiting retinal fluid after initial loading injection were more likely to show poor longterm visual outcomes 25,27 and required more intensive long-term injections 26 than those not exhibiting. Therefore, it is important to select an agent that will result in the complete resolution of the retinal fluid through the initial loading injection.…”

Section: Importance Of Predicting the Difference In Post-treatment Oc...mentioning

confidence: 99%

Prediction of anti-vascular endothelial growth factor agent-specific treatment outcomes in neovascular age-related macular degeneration using a generative adversarial network

Moon

Lee

Hwang

et al. 2023

Sci Rep

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To develop an artificial intelligence (AI) model that predicts anti-vascular endothelial growth factor (VEGF) agent-specific anatomical treatment outcomes in neovascular age-related macular degeneration (AMD), thereby assisting clinicians in selecting the most suitable anti-VEGF agent for each patient. This retrospective study included patients diagnosed with neovascular AMD who received three loading injections of either ranibizumab or aflibercept. Training was performed using optical coherence tomography (OCT) images with an attention generative adversarial network (GAN) model. To test the performance of the AI model, the sensitivity and specificity to predict the presence of retinal fluid after treatment were calculated for the AI model, an experienced (Examiner 1), and a less experienced (Examiner 2) human examiners. A total of 1684 OCT images from 842 patients (419 treated with ranibizumab and 423 treated with aflibercept) were used as the training set. Testing was performed using images from 98 patients. In patients treated with ranibizumab, the sensitivity and specificity, respectively, were 0.615 and 0.667 for the AI model, 0.385 and 0.861 for Examiner 1, and 0.231 and 0.806 for Examiner 2. In patients treated with aflibercept, the sensitivity and specificity, respectively, were 0.857 and 0.881 for the AI model, 0.429 and 0.976 for Examiner 1, and 0.429 and 0.857 for Examiner 2. In 18.5% of cases, the fluid status of synthetic posttreatment images differed between ranibizumab and aflibercept. The AI model using GAN might predict anti-VEGF agent-specific short-term treatment outcomes with relatively higher sensitivity than human examiners. Additionally, there was a difference in the efficacy in fluid resolution between the anti-VEGF agents. These results suggest the potential of AI in personalized medicine for patients with neovascular AMD.

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“…However, residual fluid after the loading phase, including subretinal fluid (SRF) and intraretinal fluid (IRF), often prompts ophthalmologists to opt for continuous treatment, influencing the course of future treatment strategies. Furthermore, such persistent fluid is associated with relatively worse visual outcomes in the long term [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Features of optical coherence tomography angiography in age-related macular degeneration with residual fluid after three loading doses of aflibercept

Song,

Seong,

Kim

et al. 2024

Eye and Vis

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Background To identify the macular neovascularization (MNV) features in exudative age-related macular degeneration (AMD) patients who exhibited residual fluid after receiving three loading doses of aflibercept. Methods Patients were classified into two groups: Group 1, which did not exhibit intraretinal fluid (IRF) and subretinal fluid (SRF), and Group 2, which did exhibit IRF and/or SRF. Optical coherence tomography angiography (OCTA) features were assessed and compared between the groups. Results A total of 101 eyes were enrolled; 65 for Group 1 and 36 for Group 2. No significant differences were found in baseline MNV size (2.94 ± 2.51 µm2 vs. 2.22 ± 2.26 µm2, P = 0.178) or vessel density (47.1 ± 15.4 % vs. 41.3 ± 10.5%, P = 0.052) between Groups 1 and 2. There were significant differences in the presence of loops (52.3% vs. 75%, P = 0.026) and peripheral arcades (29.2% vs. 55.6%, P < 0.001) at baseline between the two groups. In Group 1, there was a significant reduction in the presence of branching (P < 0.001) and loops (P = 0.016) after treatment. In Group 2, only the presence of branching decreased significantly (P < 0.001) after treatment. Multivariable analysis revealed that the presence of a peripheral arcade (B = 4.77, P = 0.001) was significantly associated with residual fluid. Conclusions Although responding to treatment, the presence of loops and peripheral arcades in exudative AMD patients may contribute to residual fluid following the three loading doses of aflibercept. The peripheral arcade, in particular, may play a more significant role in the presence of residual fluid.

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A real-world study assessing the impact of retinal fluid on visual acuity outcomes in patients with neovascular age-related macular degeneration in Korea

Cited by 8 publications

References 44 publications

Quantified Anastomotic Areas of Neovascularization as Factors Associated With Frequent Recurrence in Neovascular Age-Related Macular Degeneration

Quantified Anastomotic Areas of Neovascularization as Factors Associated With Frequent Recurrence in Neovascular Age-Related Macular Degeneration

Prediction of anti-vascular endothelial growth factor agent-specific treatment outcomes in neovascular age-related macular degeneration using a generative adversarial network

Features of optical coherence tomography angiography in age-related macular degeneration with residual fluid after three loading doses of aflibercept

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