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

Purpose: The objective of this study was to investigate the effect of multiple intravitreal ranibizumab (IVR) injections on the retinal nerve fiber layer (RNFL) in neovascular age-related macular degeneration (nAMD). Methods: One hundred sixty-eight eyes of 168 patients with nAMD who received an IVR at least 3 times were included in this prospective interventional case series. The RNFL thickness data on 80 healthy eyes, used as the control group, were obtained. The patients were grouped as follows: 3-10 injections (group 1, 62 eyes, 37%), 10-20 injections (group 2, 62 eyes, 37%), and 20 injections (group 3, 44 eyes, 26%). The RNFL thickness was measured by spectral domain optical coherence tomography. Results: The mean baseline measurement of the RNFL thickness was 97.46.4m in the control group, 96.4 +/- 5.6m in group 1, 93.8 +/- 4.6m in group 2, and 93.2 +/- 5.3m in group 3. At the last follow-up, it was 95.1 +/- 2.4m in the control group, 93.4 +/- 7.3m in group 1, 90.5 +/- 3.6m in group 2, and 89.2 +/- 4.9m in group 3 (all P values >0.050). A statistically significant difference was not found between the mean total RNFL thickness of the eyes that received injections and that of the eyes in the healthy control group (P value >0.050). A statistically significant difference was not found in all the treatment groups between the intraocular pressure level taken 1 day after the administration of the injections and that recorded preintervention (all P values >0.050). Conclusion: Repeated IVR did not lead to a significant change in RNFL thickness in patients with nAMD.