Ganglion Cell Complex Evaluation in Exudative Age-Related Macular Degeneration after Repeated Intravitreal Injections of Ranibizumab

Abstract

Purpose. To detect the effects of intravitreal ranibizumab injections on GCC in patients with wet AMD.Methods. 32 wet AMD eyes were selected and submitted at three ranibizumab injections. RTVue-OCT GCC and MM5 protocol were performed before treatment and twenty days after each injection.Results. At baseline mean GCC thickness was 93.9 ± 18.5 μm. Twenty days after each intravitreal injection it was, respectively, 85.8 ± 10.1, 86.5 ± 9.3, and 91.1 ± 11.5 μm, without statistical significance. A significant improvement in visual acuity (P= 0.031) and a reduction of mean foveal (P= 0.001) and macular thickness (P= 0.001) were observed.Conclusion. The clinical results confirm therapeutic efficacy of intravitreal injections of ranibizumab in wet AMD. A contemporary not statistically significant reduction of GCC thickness suggests that the loading phase of ranibizumab does not have any toxic effects on ganglion cell complex.

Long-term effects of intravitreal ranibizumab treatment on retinal ganglion cell complex and choroidal thickness

“…There is only one study in the literature that has looked at the short term results (after 3 intravitreal injections of ranibizumab administered monthly) of anti-VEGF therapy in humans. In that study the authors emphasized a reduction of GCC thickness but this was not statistically significant [19]. We attribute this finding to the short follow-up time in that study.…”

“…A great number of studies investigated the association between anti-VEGF treatment and RPE-choroidal atrophy by using fundus autofluorescence (FAF) or near-infrared autofluorescence, fluorescein angiogram and/or optical coherence tomography (OCT) imagings [6,[9][10][11][12][13][14][15][16]. However, there is limited study in the literature looking at the difference in retinal layers thicknesses in neovascular and nonneovascular AMD patients in order to determine the plausible effect of anti-VEGF treatment [17][18][19]. Unfortunately, all of these studies have investigated the short term effect of anti-VEGF theraphy.…”

Retinal Ganglion Cell Complex Changes after Intravitreal Bevacizumab for Diabetic Macular Edema

“…Perdicchi et al studied changes in ganglion cell complex changes after treatment of age related macular degeneration with intravitreal ranibizumab. 17 Their study showed an average of 8.1 ±20.2 m after a single injection of intravitreal ranibizumab. This decrease in retinal ganglion cell complex thickness was statistically significant, although the visual acuity and central macular thickness were reduced.…”

Ganglion Cell Layer Thickness Change in Neovascular Age-Related Macular Degeneration Treated With Anti-VEGF Injections

“…17 On the other hand, certain findings showed that the GCL-IPL decrease was not significant. 18,19,31 The objective of the present study was to elucidate the relationship between anti-VEGF injections and GCL-IPL thinning using longer follow-up and a larger sample size.…”

“…9 Other reports, however, including a meta-analysis, did not confirm these observations. 10 -12 Similarly, certain studies raised the concern that the ganglion cell layer–inner plexiform layer (GCL-IPL) is another aspect of the eye that might be affected in nAMD, 13 -17 although this remains unconfirmed 18,19 (Table 1). The goal of the present study was to assess GCL-IPL thickness changes in patients with unilateral nAMD treated with intravitreal anti-VEGF injections.…”