Effect of intravitreal anti-vascular endothelial growth factor administration on the vitreomacular interface and retinal morphology in eyes with neovascular age-related macular degeneration

To assess the effect of intravitreal anti-vascular endothelial growth factor (anti-VEGF) administration on the vitreomacular interface and retinal morphology in eyes with neovascular age-related macular degeneration (AMD) and to identify morphological markers potentially influencing disease prognosis. A total of 43 patients (51 eyes) with treatment-naive neovascular AMD subsequently treated with bevacizumab 1.25 mg (in 0.05 ml of solution) were monitored until month 12 of follow-up. Following a loading dose of three monthly intravitreal anti-VEGF injections, patients were treated as-needed (pro re nata [PRN]). Functional and morphological changes were assessed using spectral domain optical coherence tomography (SD-OCT). All study eyes showed evidence of an increase in the frequency of geographic atrophy (GA) occurrence during follow-up compared to baseline (n = 23 [45%] at month 12 compared to n = 5 [9.8%] at baseline [p > 0.05]). There was a trend towards more frequent GA in eyes diagnosed with posterior vitreomacular adhesion (PVA) at baseline that developed posterior vitreous detachment (PVD) during follow-up compared to eyes not developing PVD (35% vs. 44% GA, p 0.56). Alterations of the vitreomacular interface and retinal morphology in patients with neovascular AMD treated with bevacizumab may have a significant effect on prognosis with respect to GA development. Eyes with vitreomacular adhesion at baseline developing GA during follow-up might require more intensive anti-VEGF therapy with a decreased ability to extend treatment intervals. Findings are comparable to eyes treated with other anti-VEGF agents administered for the management of neovascular AMD.