Subfoveal Choroidal Thickness as a Potential Predictor of Clinical Response to Stereotactic Radiotherapy for Neovascular Age-Related Macular Degeneration

Abstract

Baseline SFCT may help predict which patients with nAMD will respond more favorably to SRT. The authors found eyes with a thicker baseline SFCT needed fewer IVIs after SRT. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:320-328.].

Subfoveal choriocapillaris, Sattler's and Haller's layer thickness predict clinical response to stereotactic radiotherapy in neovascular age-related macular degeneration patients

“…In this post hoc analysis, we investigated the predictive value of choroidal substructure analysis for treatment response to SRT in nAMD patients. While we previously demonstrated that subfoveal CT can be a good baseline indicator to predict SRT outcome, this study is the first to report the impact of each of the three choroidal vascular layers as well as the combination of all these choroidal metrics in this context 10 …”

“…Informed consent was obtained from all individual participants included in the study. The methodology has been reported elsewhere 10 . Briefly, medical records were screened for patients with treatment-experienced nAMD, who, in addition to pro re nata IVIs, received SRT and had at least 12 months of complete follow-up afterwards.…”

“…Various parameters, like the size of the choroidal neovascularization (CNV) and the macular volume, have turned out to be important baseline characteristics for determining the clinical response to SRT. Recently, we reported the significance of subfoveal choroidal thickness (CT) in this context, as patients who had a thicker choroid at time of irradiation responded better to SRT in terms of lesser IVIs needed to control disease activity over 12 months 10 . Vessels contribute mostly to CT, and the choroidal vasculature is subdivided into small vessels in the choriocapillaris (CC), medium-sized vessels in Sattler's layer (SL), and large-sized vessels in Haller's layer (HL) 11 .…”

The Application of Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography in Macular Diseases

“…Recently, it has been found that stereotactic radiotherapy (SRT) can reduce the number of repetitive intravitreal injections (IVIs) in patients with neovascular AMD as a new adjuvant treatment. Ranjbar et al [ 64 ] used EDI-OCT to measure SFCT and central macular thickness (CMT) in patients with neovascular AMD who received SRT and one mandatory IVI and followed up for at least 12 months. The results showed that the annual injection rate decreased from 6.86 before SRT to 3.46 afterward, and the SFCT and CMT decreased 37 μ m and 71 μ m, respectively, compared with baseline at 12-month follow-up.…”