Retinal Nerve Fiber Layer Thickness Changes in Patients with Age-Related Macular Degeneration Treated with Intravitreal Ranibizumab

Abstract

Intravitreal ranibizumab injections used to treat AMD caused a significant change in RNFL thickness after 12 months of follow-up.

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

“…A similar result was also reported by ElAshry et al The authors looked at the RNLF thickness in neovascular AMD patients receiving ranibizumab injections and demonstrated no harmful effect of intravitreal ranibizumab on RNLF thickness in the short term [17]. Conversely, Martinez-de-la-Casa et al found a significant RNLF thinning after 12 months of follow-up [18]. Another issue is how the function of the ganglion cells are being affected by that thinning.…”

“…We attribute this finding to the short follow-up time in that study. Someone may also think that intraocular pressure (IOP) fluctuations secondary to intravitreal injections might result in that GCC reduction, however it was shown in several studies that IOP spikes are limited to within the first few minutes of the injection procedure [18,21]. Surely, such peaks may have even induced GCC thinning, in time.…”

“…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 Nerve Fiber Loss in Anti-VEGF Therapy for Age-Related Macular Degeneration Can Be Decreased by Anterior Chamber Paracentesis

“…The structural effect of repeated IVIs on the peripapillary retinal nerve fiber layer (RNFL) is controversial and less well understood [13][14][15][16][17] . Repeated IOP elevations after IVI could lead to glaucomatous damage in the peripapillary RNFL.…”

“…Repeated IOP elevations after IVI could lead to glaucomatous damage in the peripapillary RNFL. In 2012, Martinez-de-la-Casa et al [14] described in a prospective study a significant decrease of RNFL thickness after 12 months of IVI treatment for nAMD. Very recently, Beck et al [18] found a significant decrease of the retinal ganglion cell layer in patients with nAMD compared to the fellow (untreated) eye during the course of long-term anti-VEGF therapy.…”