Morphological changes of macular neovascularization during long-term anti-VEGF-therapy in neovascular age-related macular degeneration

Standard

Morphological changes of macular neovascularization during long-term anti-VEGF-therapy in neovascular age-related macular degeneration. / Pauleikhoff, Daniel; Gunnemann, Marie-Luise; Ziegler, Martin; Heimes-Bussmann, Britta; Bormann, Eike; Bachmeier, Isabel; Yu, Siqing; Garcia Armendariz, Beatriz; Pauleikhoff, Laurenz.

in: PLOS ONE, Jahrgang 18, Nr. 12, 2023, S. e0288861.

Publikationen: SCORING: Beitrag in Fachzeitschrift/ZeitungSCORING: ZeitschriftenaufsatzForschungBegutachtung

Harvard

Pauleikhoff, D, Gunnemann, M-L, Ziegler, M, Heimes-Bussmann, B, Bormann, E, Bachmeier, I, Yu, S, Garcia Armendariz, B & Pauleikhoff, L 2023, 'Morphological changes of macular neovascularization during long-term anti-VEGF-therapy in neovascular age-related macular degeneration', PLOS ONE, Jg. 18, Nr. 12, S. e0288861. https://doi.org/10.1371/journal.pone.0288861

APA

Pauleikhoff, D., Gunnemann, M-L., Ziegler, M., Heimes-Bussmann, B., Bormann, E., Bachmeier, I., Yu, S., Garcia Armendariz, B., & Pauleikhoff, L. (2023). Morphological changes of macular neovascularization during long-term anti-VEGF-therapy in neovascular age-related macular degeneration. PLOS ONE, 18(12), e0288861. https://doi.org/10.1371/journal.pone.0288861

Vancouver

Bibtex

@article{25476975ee40492fa144e45d43a87c87,
title = "Morphological changes of macular neovascularization during long-term anti-VEGF-therapy in neovascular age-related macular degeneration",
abstract = "PURPOSE: To analyze the morphological changes of macular neovascularization (MNV) in exudative neovascular age-related macular degeneration under long-term intravitreal anti-vascular endothelial growth factor (VEGF) therapy in a retrospective cohort study.METHODS AND PATIENTS: We evaluated 143 nAMD eyes of 94 patients (31 male, 63 female; initial age 55-97 y, mean age 75.9 ± 7.5 y), who started anti-VEGF therapy (IVAN pro re nata (PRN) protocol) between 2009-2018 and received ongoing therapy until the last recorded visit (mean follow-up 5.3 ± 2.9 y, range 1-14 y). The mean total number of injections was 33.3 ± 19.8 with 7.0 ± 2.3 injections/year. MNV size and, if present, associated complete retinal pigment epithelium (RPE) and outer retina atrophy (cRORA) size were measured on optical coherence tomography (OCT) volume scans at the initial visit and for each year of follow-up. MNV and cRORA were identified on B-scans and their respective borders were manually transposed onto the en-face near infrared image and measured in mm2.RESULTS: MNV enlarged through follow-up, with a mean growth rate of 1.24 mm2 / year. The mean growth in MNV size was independent of initial MNV size, age, gender, MNV subtypes or number of injections per year. Nevertheless, a great interindividual variation in size and growth was observed. cRORA developed in association with increasing MNV size and its incidence increased linearly over follow-up. cRORA lesions also showed continuous growth by a rate of 1.22 mm2 / year.CONCLUSIONS: Despite frequent long-term anti-VEGF therapy, we observed ongoing MNV growth. This is consistent with the concept that the development of MNV may be a physiological biological repair mechanism to preserve RPE and photoreceptor function, provided hyperpermeability and fluid exudation are controlled. Whether recurring low VEGF levels or other factors are responsible for MNV growth remains controversial.",
keywords = "Humans, Male, Female, Aged, Aged, 80 and over, Middle Aged, Angiogenesis Inhibitors/therapeutic use, Vascular Endothelial Growth Factor A/therapeutic use, Retrospective Studies, Fluorescein Angiography, Choroidal Neovascularization/diagnostic imaging, Intravitreal Injections, Macular Degeneration/diagnostic imaging, Tomography, Optical Coherence, Wet Macular Degeneration/drug therapy",
author = "Daniel Pauleikhoff and Marie-Luise Gunnemann and Martin Ziegler and Britta Heimes-Bussmann and Eike Bormann and Isabel Bachmeier and Siqing Yu and {Garcia Armendariz}, Beatriz and Laurenz Pauleikhoff",
note = "Copyright: {\textcopyright} 2023 Pauleikhoff et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",
year = "2023",
doi = "10.1371/journal.pone.0288861",
language = "English",
volume = "18",
pages = "e0288861",
journal = "PLOS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "12",

}

RIS

TY - JOUR

T1 - Morphological changes of macular neovascularization during long-term anti-VEGF-therapy in neovascular age-related macular degeneration

AU - Pauleikhoff, Daniel

AU - Gunnemann, Marie-Luise

AU - Ziegler, Martin

AU - Heimes-Bussmann, Britta

AU - Bormann, Eike

AU - Bachmeier, Isabel

AU - Yu, Siqing

AU - Garcia Armendariz, Beatriz

AU - Pauleikhoff, Laurenz

N1 - Copyright: © 2023 Pauleikhoff et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2023

Y1 - 2023

N2 - PURPOSE: To analyze the morphological changes of macular neovascularization (MNV) in exudative neovascular age-related macular degeneration under long-term intravitreal anti-vascular endothelial growth factor (VEGF) therapy in a retrospective cohort study.METHODS AND PATIENTS: We evaluated 143 nAMD eyes of 94 patients (31 male, 63 female; initial age 55-97 y, mean age 75.9 ± 7.5 y), who started anti-VEGF therapy (IVAN pro re nata (PRN) protocol) between 2009-2018 and received ongoing therapy until the last recorded visit (mean follow-up 5.3 ± 2.9 y, range 1-14 y). The mean total number of injections was 33.3 ± 19.8 with 7.0 ± 2.3 injections/year. MNV size and, if present, associated complete retinal pigment epithelium (RPE) and outer retina atrophy (cRORA) size were measured on optical coherence tomography (OCT) volume scans at the initial visit and for each year of follow-up. MNV and cRORA were identified on B-scans and their respective borders were manually transposed onto the en-face near infrared image and measured in mm2.RESULTS: MNV enlarged through follow-up, with a mean growth rate of 1.24 mm2 / year. The mean growth in MNV size was independent of initial MNV size, age, gender, MNV subtypes or number of injections per year. Nevertheless, a great interindividual variation in size and growth was observed. cRORA developed in association with increasing MNV size and its incidence increased linearly over follow-up. cRORA lesions also showed continuous growth by a rate of 1.22 mm2 / year.CONCLUSIONS: Despite frequent long-term anti-VEGF therapy, we observed ongoing MNV growth. This is consistent with the concept that the development of MNV may be a physiological biological repair mechanism to preserve RPE and photoreceptor function, provided hyperpermeability and fluid exudation are controlled. Whether recurring low VEGF levels or other factors are responsible for MNV growth remains controversial.

AB - PURPOSE: To analyze the morphological changes of macular neovascularization (MNV) in exudative neovascular age-related macular degeneration under long-term intravitreal anti-vascular endothelial growth factor (VEGF) therapy in a retrospective cohort study.METHODS AND PATIENTS: We evaluated 143 nAMD eyes of 94 patients (31 male, 63 female; initial age 55-97 y, mean age 75.9 ± 7.5 y), who started anti-VEGF therapy (IVAN pro re nata (PRN) protocol) between 2009-2018 and received ongoing therapy until the last recorded visit (mean follow-up 5.3 ± 2.9 y, range 1-14 y). The mean total number of injections was 33.3 ± 19.8 with 7.0 ± 2.3 injections/year. MNV size and, if present, associated complete retinal pigment epithelium (RPE) and outer retina atrophy (cRORA) size were measured on optical coherence tomography (OCT) volume scans at the initial visit and for each year of follow-up. MNV and cRORA were identified on B-scans and their respective borders were manually transposed onto the en-face near infrared image and measured in mm2.RESULTS: MNV enlarged through follow-up, with a mean growth rate of 1.24 mm2 / year. The mean growth in MNV size was independent of initial MNV size, age, gender, MNV subtypes or number of injections per year. Nevertheless, a great interindividual variation in size and growth was observed. cRORA developed in association with increasing MNV size and its incidence increased linearly over follow-up. cRORA lesions also showed continuous growth by a rate of 1.22 mm2 / year.CONCLUSIONS: Despite frequent long-term anti-VEGF therapy, we observed ongoing MNV growth. This is consistent with the concept that the development of MNV may be a physiological biological repair mechanism to preserve RPE and photoreceptor function, provided hyperpermeability and fluid exudation are controlled. Whether recurring low VEGF levels or other factors are responsible for MNV growth remains controversial.

KW - Humans

KW - Male

KW - Female

KW - Aged

KW - Aged, 80 and over

KW - Middle Aged

KW - Angiogenesis Inhibitors/therapeutic use

KW - Vascular Endothelial Growth Factor A/therapeutic use

KW - Retrospective Studies

KW - Fluorescein Angiography

KW - Choroidal Neovascularization/diagnostic imaging

KW - Intravitreal Injections

KW - Macular Degeneration/diagnostic imaging

KW - Tomography, Optical Coherence

KW - Wet Macular Degeneration/drug therapy

U2 - 10.1371/journal.pone.0288861

DO - 10.1371/journal.pone.0288861

M3 - SCORING: Journal article

C2 - 38134207

VL - 18

SP - e0288861

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 12

ER -