Predicting response of exudative age-related macular degeneration to Bevacizumab based on spectralis optical coherence tomography

Purpose: To identify baseline optical coherence tomography factors in exudative age-related macular degeneration that predict response to bevacizumab injections. Methods: Patients underwent spectral domain optical coherence tomography at diagnosis and the width, height, area, and location of the subretinal fluid, intraretinal fluid, pigment epithelial detachment, and subretinal tissue were measured. The location and size of photoreceptor and the loss of retinal pigment epithelium were recorded as well as quantitative retinal measurements. Patients received three consecutive monthly injections of bevacizumab after which their best-corrected visual acuity was recorded. Results: Overall 105 eyes of 105 patients aging 88 ± 8.6 years were included. In univariate correlational analyses, only subretinal fluid width demonstrated a significant positive correlation with improved best-corrected visual acuity (R 2 0.230, P 0.018). Eyes with intraretinal fluid (P 0.020) and retinal pigment epithelial loss (P 0.009) located in the subfoveal (as opposed to the juxtafoveal area) demonstrating worst visual outcomes. In stepwise backwards regression, the subretinal fluid width and intraretinal fluid location were the only parameters that remained significant explaining 9.23% of the variation in delta best-corrected visual acuity scores. Conclusion: Improvement in best-corrected visual acuity after three injections of bevacizumab can be predicted from optical coherence tomography measurements. Specifically, the authors identified subretinal fluid width and intraretinal fluid location as significant markers.