المؤلفون: Fung, Adrian T.^1,2 (AUTHOR), Waldstein, Sebastian M.^1,3 (AUTHOR) sebastian.waldstein@meduniwien.ac.at, Gal-Or, Orly^4,5,6 (AUTHOR), Pellegrini, Marco⁷ (AUTHOR), Preziosa, Chiara⁷ (AUTHOR), Shields, Jerry A.⁸ (AUTHOR), Welch, R. Joel⁸ (AUTHOR), Dolz-Marco, Rosa^4,5,9 (AUTHOR), Sarraf, David^10,11 (AUTHOR), Nagiel, Aaron^10,11 (AUTHOR), Lalane, Robert^10,11 (AUTHOR), Jung, Jesse J.^12,13 (AUTHOR), Ghazi, Nicola G.¹⁴ (AUTHOR), Ramtohul, Prithvi¹⁵ (AUTHOR), Arnold, Jennifer J.¹⁶ (AUTHOR), Sakurada, Yoichi^4,5,17 (AUTHOR), Choudhry, Netan¹⁸ (AUTHOR), Balaratnasingam, Chandrakumar^19,20 (AUTHOR), Freund, K. Bailey^4,5 (AUTHOR), Shields, Carol L.⁸ (AUTHOR)

المصدر: Ophthalmology. Nov2020, Vol. 127 Issue 11, p1567-1577. 11p.

مصطلحات موضوعية: *POLYPOIDAL choroidal vasculopathy, *OPTIC disc, *RHODOPSIN, *COLOR photography, *INDOCYANINE green, *SCLERA

مستخلص: To evaluate multimodal imaging findings of solitary idiopathic choroiditis (SIC; also known as unifocal helioid choroiditis) to clarify its origin, anatomic location, and natural course. Multicenter retrospective observational case series. Sixty-three patients with SIC in 1 eye. Demographic and clinical data were collected. Multimodal imaging included color fundus photography, OCT (including swept-source OCT), OCT angiography (OCTA), fundus autofluorescence, fluorescein and indocyanine green angiography, and B-scan ultrasonography. Standardized grading of imaging features. Mean age at presentation was 56 ± 15 years (range, 12–83 years). Mean follow-up duration in 39 patients was 39 ± 55 months (range, 1 month–25 years). The lesions measured a mean of 2.4 × 2.1 mm in basal diameter, were located inferior (64%) or nasal to the optic disc, and appeared yellow (53%). No systemic associations were found. The lesions all appeared as an elevated subretinal mass, with OCT demonstrating all lesions to be confined to the sclera, not the choroid. On OCT, the deep lesion margin was visible in 12 eyes with a mean lesion thickness of 0.6 mm. Overlying choroidal thinning or absence was seen in 95% (mean choroidal thickness, 28 ± 35 μm). Mild subretinal fluid was observed overlying the lesions in 9 patients (14%). Retinal pigment epithelial disruption and overlying retinal thinning was observed in 56% and 57%, respectively. OCT angiography was performed in 13 eyes and demonstrated associated choroidal and lesional flow voids. Four lesions (6%) were identified at the macula, leading to visual loss in 1 patient. One lesion demonstrated growth and another lesion showed spontaneous resolution. In this largest series to date, multimodal imaging of SIC demonstrated a scleral location in all patients. The yellow and white clinical appearance may be related to scleral unmasking resulting from atrophy of overlying tissues. Additional associated features included documentation of deep margin on swept-source OCT, trace subretinal fluid in a few patients, and OCTA evidence of lesional flow voids. Because of the scleral location of this lesion in every patient, a new name, focal scleral nodule, is proposed. [ABSTRACT FROM AUTHOR]

المؤلفون: Schlegl, Thomas^1,2, Waldstein, Sebastian M.³, Bogunovic, Hrvoje¹, Endstraßer, Franz¹, Sadeghipour, Amir¹, Philip, Ana-Maria⁴, Podkowinski, Dominika⁴, Gerendas, Bianca S.³, Langs, Georg², Schmidt-Erfurth, Ursula^1,3 ursula.schmidt-erfurth@meduniwien.ac.at

المصدر: Ophthalmology. Apr2018, Vol. 125 Issue 4, p549-558. 10p.

مصطلحات موضوعية: *OPTICAL coherence tomography, *DEEP learning, *PEARSON correlation (Statistics), *OPHTHALMOLOGY, *RETINAL degeneration

مستخلص: Purpose Development and validation of a fully automated method to detect and quantify macular fluid in conventional OCT images. Design Development of a diagnostic modality. Participants The clinical dataset for fluid detection consisted of 1200 OCT volumes of patients with neovascular age-related macular degeneration (AMD, n = 400), diabetic macular edema (DME, n = 400), or retinal vein occlusion (RVO, n = 400) acquired with Zeiss Cirrus (Carl Zeiss Meditec, Dublin, CA) (n = 600) or Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany) (n = 600) OCT devices. Methods A method based on deep learning to automatically detect and quantify intraretinal cystoid fluid (IRC) and subretinal fluid (SRF) was developed. The performance of the algorithm in accurately identifying fluid localization and extent was evaluated against a manual consensus reading of 2 masked reading center graders. Main Outcome Measures Performance of a fully automated method to accurately detect, differentiate, and quantify intraretinal and SRF using area under the receiver operating characteristics curves, precision, and recall. Results The newly designed, fully automated diagnostic method based on deep learning achieved optimal accuracy for the detection and quantification of IRC for all 3 macular pathologies with a mean accuracy (AUC) of 0.94 (range, 0.91–0.97), a mean precision of 0.91, and a mean recall of 0.84. The detection and measurement of SRF were also highly accurate with an AUC of 0.92 (range, 0.86–0.98), a mean precision of 0.61, and a mean recall of 0.81, with superior performance in neovascular AMD and RVO compared with DME, which was represented rarely in the population studied. High linear correlation was confirmed between automated and manual fluid localization and quantification, yielding an average Pearson's correlation coefficient of 0.90 for IRC and of 0.96 for SRF. Conclusions Deep learning in retinal image analysis achieves excellent accuracy for the differential detection of retinal fluid types across the most prevalent exudative macular diseases and OCT devices. Furthermore, quantification of fluid achieves a high level of concordance with manual expert assessment. Fully automated analysis of retinal OCT images from clinical routine provides a promising horizon in improving accuracy and reliability of retinal diagnosis for research and clinical practice in ophthalmology. [ABSTRACT FROM AUTHOR]

المؤلفون: Tadayoni, Ramin¹ ramin.tadayoni@aphp.fr, Waldstein, Sebastian M.², Boscia, Francesco³, Gerding, Heinrich^4,5, Gekkieva, Margarita⁶, Barnes, Elizabeth⁶, Das Gupta, Ayan⁷, Wenzel, Andreas⁶, Pearce, Ian⁸

المصدر: Ophthalmology. Dec2017, Vol. 124 Issue 12, p1778-1787. 10p.

مصطلحات موضوعية: *RETINAL vein occlusion, *RANIBIZUMAB, *LASERS in ophthalmology, *DRUG administration, *DRUG efficacy, *THERAPEUTICS

مستخلص: Purpose To evaluate the long-term (24-month) efficacy and safety of ranibizumab 0.5 mg administered pro re nata (PRN) with or without laser using an individualized visual acuity (VA) stabilization criteria in patients with visual impairment due to macular edema secondary to branch retinal vein occlusion (BRVO). Design Phase IIIb, open-label, randomized, active-controlled, 3-arm, multicenter study. Participants A total of 455 patients. Methods Patients were randomized (2:2:1) to ranibizumab 0.5 mg (n = 183), ranibizumab 0.5 mg with laser (n = 180), or laser (with optional ranibizumab 0.5 mg after month 6; n = 92). After initial 3 monthly injections, patients in the ranibizumab with or without laser arms received VA stabilization criteria-driven PRN treatment. Patients assigned to the laser arm received laser at the investigator's discretion. Main Outcome Measures Mean (and mean average) change in best-corrected visual acuity (BCVA) and central subfield thickness (CSFT) from baseline to month 24, and safety over 24 months. Results A total of 380 patients (83.5%) completed the study. Ranibizumab with or without laser led to superior BCVA outcomes versus laser (monotherapy and combined with ranibizumab from month 6; 17.3/15.5 vs. 11.6 letters; P < 0.0001). Ranibizumab with laser was noninferior to ranibizumab monotherapy (mean average BCVA change: 15.4 vs. 15.0 letters; P < 0.0001). However, addition of laser did not reduce the number of ranibizumab injections (mean injections: 11.4 vs. 11.3; P = 0.4259). A greater reduction in CSFT was seen with ranibizumab with or without laser versus laser monotherapy over 24 months from baseline (ranibizumab monotherapy −224.7 μm, ranibizumab with laser −248.9 μm, laser [monotherapy and combined with ranibizumab from month 6] −197.5 μm). Presence of macular ischemia did not affect BCVA outcome or treatment frequency. There were no reports of neovascular glaucoma or iris neovascularization. No new safety signals were identified. Conclusions The BRIGHTER study results confirmed the long-term efficacy and safety profile of PRN dosing driven by individualized VA stabilization criteria using ranibizumab 0.5 mg in patients with BRVO. Addition of laser did not lead to better functional outcomes or lower treatment need. The safety results were consistent with the well-established safety profile of ranibizumab. [ABSTRACT FROM AUTHOR]

المؤلفون: Waldstein, Sebastian M.¹, Simader, Christian¹, Staurenghi, Giovanni², Chong, N. Victor³, Mitchell, Paul⁴, Jaffe, Glenn J.⁵, Lu, Chengxing⁶, Katz, Todd A.⁶, Schmidt-Erfurth, Ursula¹ ursula.schmidt-erfurth@meduniwien.ac.at

المصدر: Ophthalmology. Jul2016, Vol. 123 Issue 7, p1521-1529. 9p.

مصطلحات موضوعية: *RETINAL degeneration treatment, *RANIBIZUMAB, *VISUAL acuity, *NEOVASCULARIZATION, *BIOPHARMACEUTICS, *RETINAL anatomy, *THERAPEUTICS, AGE factors in retinal degeneration

مستخلص: Purpose To compare the efficacy of intravitreal aflibercept and ranibizumab on the exudative activity of neovascular age-related macular degeneration (nAMD) using optical coherence tomography (OCT) and to correlate morphologic findings with visual acuity (VA) outcomes. Design Post hoc analysis of the prospective VIEW trials. Participants Data of 1815 patients randomized to 0.5 mg ranibizumab every 4 weeks (Q4wks), 2 mg aflibercept Q4wks, or 2 mg aflibercept every 8 weeks (Q8wks). Methods Standardized OCT evaluation was performed by masked reading centers for the presence of intraretinal cystoid fluid (IRC), subretinal fluid (SRF), and pigment epithelial detachment (PED). Rates of feature resolution were compared between drugs and regimen. Associations between morphologic features and VA were analyzed using multivariate modeling. Main Outcome Measures Resolution rates of IRC, SRF, and PED, and associations between morphology and VA. Results At baseline, the proportions of eyes with IRC, SRF, and PED were balanced between the aflibercept and ranibizumab groups. At week 12, IRC resolved in 50% of eyes with both agents. Subretinal fluid resolved in 70% of pooled aflibercept-treated eyes and in 59% of ranibizumab-treated eyes, and PED resolved in 29% and 24% of pooled aflibercept-treated eyes and ranibizumab-treated eyes, respectively. At week 52, IRC resolved in 57% (aflibercept Q4wks), 50% (aflibercept Q8wks), and 52% (ranibizumab) of patients; SRF resolved in 75% (both aflibercept Q4wks/Q8wks) and 66% (ranibizumab) of patients; and PED resolved in 40% (aflibercept Q4wks), 34% (aflibercept Q8wks), and 28% (ranibizumab) of patients. During fixed dosing (weeks 12–52) all exudative features showed synchronized fluctuations after treatment-free visits in the Q8wks aflibercept regimen. During pro re nata dosing (weeks 52–96), greater proportions of patients showed recurrent fluid in all treatment arms. Presence of IRC was generally associated with lower VA at baseline, which translated into poorer final VA outcomes. Conclusions Fluid resolution in all compartments was consistently greater for aflibercept Q4wks than for aflibercept Q8wks and ranibizumab. At week 52, Q8wks aflibercept–treated eyes were, on average, as dry as or drier than with ranibizumab despite the extended treatment interval. Independent of agent or regimen, preexisting morphologic features of the retina at baseline markedly influenced VA outcomes. [ABSTRACT FROM AUTHOR]

المؤلفون: Tadayoni, Ramin¹ ramin.tadayoni@aphp.fr, Waldstein, Sebastian M.², Boscia, Francesco³, Gerding, Heinrich^4,5, Pearce, Ian⁶, Priglinger, Siegfried⁷, Wenzel, Andreas⁸, Barnes, Elizabeth⁸, Gekkieva, Margarita⁸, Pilz, Stefan⁹, Monés, Jordi¹⁰

المصدر: Ophthalmology. Jun2016, Vol. 123 Issue 6, p1332-1344. 13p.

مصطلحات موضوعية: *RETINAL vein occlusion, *VISION disorders, *LUCENTIS (Drug), *MEDICAL lasers, *RANDOMIZED controlled trials, *LONGITUDINAL method, *THERAPEUTICS

مستخلص: Purpose To compare the 6-month efficacy and safety profile of an individualized stabilization criteria–driven pro re nata (PRN) regimen of ranibizumab 0.5 mg with or without laser versus laser alone in patients with visual impairment due to macular edema secondary to branch retinal vein occlusion (BRVO). Design A 24-month, prospective, open-label, randomized, active-controlled, multicenter, phase IIIb study. Participants A total of 455 patients. Methods Eligible patients were randomized 2:2:1 to receive ranibizumab (n = 183), ranibizumab with laser (n = 180), or laser only (n = 92). Patients treated with ranibizumab with or without laser received a minimum of 3 initial monthly ranibizumab injections until visual acuity (VA) stabilization, and VA-based PRN dosing thereafter. In the ranibizumab with laser and laser-only groups, laser was given at the investigator's discretion at a minimum interval of 4 months and if VA was <79 letters. Main Outcome Measures Mean change from baseline at month 6 in best-corrected visual acuity (BCVA) (primary end point) and central subfield thickness, and safety over 6 months. Exploratory objectives were to evaluate the influence of baseline BCVA, disease duration, and ischemia on BCVA outcomes at month 6. Results Baseline mean BCVA was 57.7 letters, and mean BRVO duration was 9.9 months. Ranibizumab with or without laser was superior to laser only in improving mean BCVA from baseline at month 6 (14.8 and 14.8 vs. 6.0 letters; both P < 0.0001; primary end point met). Patients with a shorter BRVO duration at baseline had a higher mean BCVA gain than those with a longer BRVO duration. Patients with a poor baseline VA had a better BCVA gain than those with a higher baseline VA, although final BCVA was lower in those with poor baseline VA. In the ranibizumab with or without laser groups, the presence of some macular ischemia at baseline did not influence mean BCVA gains. There were no new ocular or nonocular safety events. Conclusions Ranibizumab with an individualized VA-based regimen, with or without laser, showed statistically significant superior improvement in BCVA compared with laser alone in patients with BRVO. Overall, there were no new safety events other than those reported in previous studies. [ABSTRACT FROM AUTHOR]

المؤلفون: Larsen, Michael¹ miclar01@regionh.dk, Waldstein, Sebastian M.², Boscia, Francesco³, Gerding, Heinrich⁴, Monés, Jordi⁵, Tadayoni, Ramin⁶, Priglinger, Siegfried⁷, Wenzel, Andreas⁸, Barnes, Elizabeth⁸, Pilz, Stefan⁸, Stubbings, William⁸, Pearce, Ian⁹

المصدر: Ophthalmology. May2016, Vol. 123 Issue 5, p1101-1111. 11p.

مصطلحات موضوعية: *RETINAL vein occlusion, *RANIBIZUMAB, *DRUG efficacy, *MEDICATION safety, *METABOLIC disorder treatment, *EDEMA, *THERAPEUTICS

مستخلص: Purpose To assess the 12-month efficacy and safety profile of an individualized regimen of ranibizumab 0.5 mg driven by stabilization criteria in patients with macular edema secondary to central retinal vein occlusion (CRVO). Design A 24-month, prospective, open-label, single-arm, multicenter study. Participants Three hundred fifty-seven patients. Methods Patients were treated with monthly ranibizumab 0.5-mg injections (minimum of 3 injections) until stable visual acuity (VA) was maintained for 3 consecutive months. Thereafter, ranibizumab 0.5 mg was dosed as needed if monthly monitoring indicated a loss of VA resulting from disease activity. Main Outcome Measures Mean change from baseline at month 12 in best-corrected VA (BCVA; primary end point) and safety over 12 months. The efficacy of this regimen in subgroups categorized by baseline BCVA score, CRVO duration, or presence of macular ischemia (exploratory analysis). Results At baseline, the mean BCVA was 53.0 letters and mean CRVO duration was 8.9 months (median, 2.4 months). Ranibizumab 0.5-mg treatment resulted in a statistically significant mean gain in BCVA from baseline at month 12 of 12.3 letters (standard deviation [SD], 16.72 letters; P < 0.0001). The mean number of ranibizumab injections up to month 12 was 8.1 (SD, 2.77). At month 12, mean BCVA gains were similar with or without macular ischemia at baseline (11.6 vs. 12.1 letters); the mean BCVA gain was higher with baseline CRVO duration of less than 3 months (13.4 letters) than with a longer duration (≥3–<9 months, 11.1 letters; ≥9 months, 10.9 letters). Patients with lower baseline BCVA had larger mean BCVA gains at month 12 than those with higher baseline BCVA (≤39/40–59/≥60 and 18.0/12.7/8.9 letters, respectively), although the absolute BCVA at month 12 was higher with higher baseline BCVA. No new ocular or nonocular safety events were observed. Conclusions An individualized dosing regimen of ranibizumab 0.5 mg driven by stabilization criteria for up to 12 months resulted in significant BCVA gain in a broad population of patients with macular edema secondary to CRVO, including those with macular ischemia at baseline. The safety findings were consistent with those reported in previous ranibizumab studies in patients with CRVO. [ABSTRACT FROM AUTHOR]

المؤلفون: Waldstein, Sebastian M.¹, Wright, Jonathan², Warburton, James³, Margaron, Philippe³, Simader, Christian¹, Schmidt-Erfurth, Ursula¹ ursula.schmidt-erfurth@meduniwien.ac.at

المصدر: Ophthalmology. Jan2016, Vol. 123 Issue 1, p60-69. 10p.

مصطلحات موضوعية: *VISUAL acuity, *RANIBIZUMAB, *RETINAL degeneration treatment, *OPTICAL coherence tomography, *VITREOUS body diseases

مستخلص: Purpose To establish the predictive value of defined retinal morphologic parameters on visual outcomes and re-treatment needs in patients with neovascular age-related macular degeneration (nAMD) receiving ranibizumab treatment. Design Post hoc analysis of a prospective, 12-month, multicenter, phase IIIb trial. Participants Three hundred fifty-three treatment-naïve patients with nAMD. Methods Available data from 319 treatment-naïve patients receiving ranibizumab 0.3 mg monthly (frequent regimen; n = 102) or ranibizumab 0.3 or 0.5 mg quarterly (pooled 0.3/0.5 mg = infrequent regimen; n = 217) were analyzed to assess the correlations between baseline retinal morphologic parameters and best-corrected visual acuity (BCVA) change (structure–function correlations). The BCVA was measured at monthly visits. Optical coherence tomography scans were acquired monthly for quantitative measures of the central retinal thickness and qualitative assessment of retinal morphologic features. Assessed morphologic parameters included intraretinal cystoid fluid (IRC), subretinal fluid (SRF), pigment epithelial detachment, and vitreomacular interface configuration classification comprising vitreomacular adhesion and posterior vitreous detachment (PVD). An analysis of covariance was conducted to evaluate the impact of retinal morphologic features on BCVA change at month 12. Main Outcome Measures Change in BCVA from baseline to month 12 compared between frequent and infrequent treatment arms. Results Relevant predictive factors for BCVA change at month 12 were baseline SRF ( P = 0.05), PVD ( P = 0.03), IRC ( P = 0.05), treatment frequency ( P < 0.01), and BCVA ( P < 0.01). The presence of both SRF and PVD at baseline was associated with similar BCVA gains regardless of treatment frequency (mean difference in BCVA gains at month 12 of +2.6 letters in favor of infrequent treatment). Subretinal fluid was present in 71% of patients, and PVD was present in 64% of patients. Conclusions In patients with both SRF and PVD at baseline, similar BCVA outcomes were observed regardless of treatment frequency. These patients may require less frequent treatments compared with patients without SRF, without PVD, or without either who may require more frequent injections for maintenance of vision. This finding may have implications in clinical practice by helping to tailor an individualized re-treatment interval in nAMD patients. [ABSTRACT FROM AUTHOR]

المؤلفون: Schmidt-Erfurth, Ursula^1,2 ursula.schmidt-erfurth@meduniwien.ac.at, Waldstein, Sebastian M.^1,2, Deak, Gabor-Gyoergy^1,2, Kundi, Michael³, Simader, Christian^1,2

المصدر: Ophthalmology. Apr2015, Vol. 122 Issue 4, p822-832. 11p.

مصطلحات موضوعية: *RETINAL degeneration treatment, *RHODOPSIN, *EYE color, *BLINDNESS, *NEOVASCULARIZATION

مستخلص: Purpose Intravitreal antiangiogenic therapy is the major therapeutic breakthrough in neovascular age-related macular degeneration (AMD). Optical coherence tomography (OCT) is the leading diagnostic tool, but solid criteria for optimal therapeutic outcomes are lacking. A comprehensive analysis of structure/function correlations using Food and Drug Administration- and European Medicines Agency–approved substances and fixed and flexible regimens was performed. Design Post hoc analysis of a prospective, randomized multicenter clinical trial including 189 study sites. Participants A total of 1240 patients with active neovascular AMD. Methods Participants received intravitreal ranibizumab or aflibercept. A fixed regimen was used for 48 weeks followed by a flexible regimen until week 96. At monthly intervals, best-corrected visual acuity (BCVA) was measured and retinal morphology was assessed by standardized OCT, including intraretinal cysts (IRCs), subretinal fluid (SRF), and pigment epithelial detachment (PED), presenting with a width ≥400 μm or a height of ≥200 μm. Results were correlated for each regimen, feature, and time. Main Outcome Measures The BCVA outcomes in relation to retinal pathomorphology based on noninferiority for all treatment arms. Results In neovascular AMD, only IRC at baseline and persistent through week 12 had a negative impact on BCVA. With therapeutic intervention, exudative features such as IRC and SRF resolved rapidly in 74% of eyes, whereas PED responded only slowly with 38%. Independent of the type of regimen, fixed or flexible, retinal morphology correlated tightly with visual function. Intraretinal cysts consistently showed the lowest BCVA gains with either regimen or substance. With the switch from a fixed to a flexible pro re nata (PRN) regimen, progressive visual loss occurred exclusively in the group with primary PED presenting as the hallmark of neovascular activity and was induced by secondary formation of IRC in the neurosensory retina. Conclusions The efficacy of antiangiogenic therapy in neovascular AMD is strongly determined by morphologic features. The subretinal pigment epithelium lesion underlying PED appears to be the primary indicator for progressive disease activity, whereas secondary cystoid degeneration is the most relevant imaging marker for visual function. Clinically, PED emerged as trigger for consecutive vision loss in PRN treatment. [ABSTRACT FROM AUTHOR]

المؤلفون: Mayr-Sponer, Ulrike¹, Waldstein, Sebastian M.¹, Kundi, Michael², Ritter, Markus¹, Golbaz, Isabelle¹, Heiling, Ursula¹, Papp, Andrea¹, Simader, Christian¹, Schmidt-Erfurth, Ursula¹ ursula.schmidt-erfurth@meduniwien.ac.at

المصدر: Ophthalmology. Dec2013, Vol. 120 Issue 12, p2620-2629. 10p.

مصطلحات موضوعية: *LUCENTIS (Drug), *RETINAL degeneration treatment, *NEOVASCULARIZATION, *OPTICAL coherence tomography, *OPHTHALMOLOGY, *EYE diseases

مستخلص: Purpose: To investigate the influence of the vitreomacular interface (VMI) on the functional and anatomic efficacy of ranibizumab therapy in patients with neovascular age-related macular degeneration (AMD). Design: Subanalysis of a prospective, 12-month, multicenter, phase IIIb trial. Participants: A total of 353 treatment-naïve patients with subfoveal choroidal neovascularization (CNV) receiving quarterly or monthly ranibizumab therapy. Methods: On monthly optical coherence tomography (OCT) scan sets, the VMI configuration was graded by a certified reading center into one of the following conditions: continuous posterior vitreoretinal attachment (PVA), vitreomacular adhesion (VMA), partial vitreous detachment without vitreomacular contact, or complete posterior vitreous detachment (PVD). Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) measurements were performed at monthly intervals. Analysis included patients with a minimum of 10 OCT examinations, including baseline and month 12 (n = 251). After integration of the VMI configuration over 12 months, patients were divided into one of the following categories: PVD (n = 162), release of vitreomacular contact (RELEASE; n = 48), VMA (n = 37), or PVA (n = 4). General estimation equation analyses were applied to test for noninferiority of quarterly versus monthly treatment. Main Outcome Measures: The BCVA and CRT changes at month 12. Results: Mean BCVA changes in letters were +4.7 (PVD), +3.2 (RELEASE), and −0.2 (VMA) in the quarterly regimen and +4.9 (PVD), +12.7 (RELEASE), and +7.5 (VMA) in the monthly regimen. No difference in therapeutic efficiency between monthly and quarterly intervention was found in eyes with PVD, and quarterly treatment was noninferior to monthly treatment (P = 0.001). However, monthly treatment was superior to quarterly treatment in the RELEASE (P = 0.008) and VMA (P = 0.043) groups. Mean CRT changes were −98 and −96 μm (PVD), −117 and −136 μm (RELEASE), and −93 and −87 μm (VMA) in the monthly and quarterly regimens, respectively, without statistically significant differences. Conclusions: The configuration of the VMI seems to have an important effect on visual outcomes and need for retreatment. In patients with PVD, a lower treatment frequency may be feasible, whereas patients with RELEASE or VMA may benefit from intensive retreatment. These findings may serve as a basis for individualized treatment decisions in anti-angiogenic therapy of neovascular AMD and perhaps other indications. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. [ABSTRACT FROM AUTHOR]

المؤلفون: Fung, Adrian T.^1,2 (AUTHOR), Waldstein, Sebastian M.^1,3 (AUTHOR) Sebastian.waldstein@meduniwien.ac.at, Gal-Or, Orly^4,5,6 (AUTHOR), Pellegrini, Marco⁷ (AUTHOR), Freund, K. Bailey^4,5,6 (AUTHOR), Shields, Carol L.⁸ (AUTHOR)

المصدر: Ophthalmology. Apr2021, Vol. 128 Issue 4, pe23-e23. 1p.