Choroidal thickness and visual prognosis in type 1 lesion due to neovascular age-related macular degeneration

To evaluate the association between subfoveal choroidal thickness and the visual outcome in eyes with type 1 choroidal neovascularization (CNV) due to neovascular age-related macular degeneration (nAMD).

This was a retrospective, longitudinal, cross-sectional study including patients diagnosed with nAMD type 1 lesions managed with intravitreal injections of ranibizumab in a PRN strategy during 24 months. Retrospective chart review of patients with type 1 CNV recording the visual acuity, number of intravitreal injections, multimodal imaging data, and follow-up period was performed. Subfoveal choroidal thickness was measured using enhanced depth imaging scans obtained with spectral-domain optical coherence tomography.

Twenty-five eyes of 21 patients were included. The mean baseline logMAR best-corrected visual acuity was 0.52 (+0.35) (median 0.5; range 0.1-1; interquartile range (IQR) 0.3-0.8) and improved to 0.39 (+0.39) (median 0.4; range 0.1-1; IQR 0.2-0.5) by the end of the follow-up (p = 0.038). Subfoveal choroidal thickness was 202.8 (+60.3) μm (median 218; range 81-285; IQR 146-258). Statistical mixed effects model demonstrated an association between rate of improvement of visual acuity with subfoveal choroidal thickness after 24 months (p<0.001) (95% confidence interval 0.0002-0.0001 logMAR month μm); higher thickness values were correlated with better visual acuity.

Thicker subfoveal choroid was associated with better visual outcomes in patients with type 1 CNV due to nAMD following a strict PRN regimen with intravitreal ranibizumab at 24 months of follow-up.