Anti-vascular endothelial growth factor intravitreal therapy and macular ganglion cell layer thickness in patients with neovascular age-related macular degeneration

Purpose: To assess macular ganglion cell layer (GCL) thickness in patients treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) for exudative age-related macular degeneration (AMD). Materials and Methods: This was a two-year retrospective institutional case series where records of patients treated with anti-VEGF injections for unilateral AMD were reviewed for BCVA, intraocular pressure, and spectral domain optical coherence tomography. Macular GCL thickness was evaluated with automated retinal segmentation based on ETDRS grid rings. Retinal layer segmentation was carefully assessed and manually corrected for any misalignment. Results: 48 eyes of 24 patients with unilateral exudative AMD were included. The mean number of anti-VEGF injections was 10.4 ± 3.2. Fellow eyes were classified as AREDS category one and two. There was significant thinning of the 3-mm macular GCL in treated compared with fellow eyes at one and two years (P =.03 and P =.04, respectively). GCL thickness compared to baseline showed a significant decrease at one and two years in treated (P =.01 and <0.0001) and at two years in untreated fellow eyes (P =.02). Conclusions: There is a decrease of macular GCL thickness in eyes with exudative AMD treated with anti-VEGF intravitreal injections in comparison with fellow eyes. There is longitudinal thinning of the GCL from baseline in eyes with both treated exudative and non-treated early AMD.