Specific alterations in the retinal microstructure in neovascular age-related macular degeneration under anti-VEGF therapy

High-definition raster scanning spectral-domain optical coherence tomography (SD-OCT) allows a precise assessment of retinal layers and a more detailed detection of subtle morphological alterations. The aim of this study was to observe such changes in patients with neovascular age-related macular degeneration (nAMD) under anti-VEGF therapy and to evaluate if they show characteristic and reversible properties. The study included 20 consecutive patients with untreated nAMD. SD-OCT with an axial resolution of 6 A mu m and a scan velocity of up to 25,000 A-scans/s was used for high-resolution imaging of the macular region at baseline and at months 1 and 3. Characteristic changes in the retinal microstructure were documented and analyzed. Obvious morphological changes as well as discrete intraretinal alterations showed a clear improvement until the third month following the initial ranibizumab injection. Destructions of the neurosensory retina and the outer retinal layers were partly reversible and significantly reduced after treatment was applied. SD-OCT was able to detect additional information on specific morphological alterations within the retina. These changes showed a considerable reduction under consistent treatment indicating their potential value for monitoring treatment success in antiangiogenic strategies.