Retinal Nerve Fiber Layer Thickness Changes in Age-Related Macular Degeneration Treated with Multiple Intravitreal...

The objective of this study was to investigate the effect of multiple intravitreal ranibizumab (IVR) injections on the retinal nerve fiber layer (RNFL) in neovascular age-related macular degeneration (nAMD).

One hundred sixty-eight eyes of 168 patients with nAMD who received an IVR at least 3 times were included in this prospective interventional case series. The RNFL thickness data on 80 healthy eyes, used as the control group, were obtained. The patients were grouped as follows: 3-10 injections (group 1, 62 eyes, 37%), 10-20 injections (group 2, 62 eyes, 37%), and ≥20 injections (group 3, 44 eyes, 26%). The RNFL thickness was measured by spectral domain optical coherence tomography.

The mean baseline measurement of the RNFL thickness was 97.4 ± 6.4 μm in the control group, 96.4 ± 5.6 μm in group 1, 93.8 ± 4.6 μm in group 2, and 93.2 ± 5.3 μm in group 3. At the last follow-up, it was 95.1 ± 2.4 μm in the control group, 93.4 ± 7.3 μm in group 1, 90.5 ± 3.6 μm in group 2, and 89.2 ± 4.9 μm in group 3 (all P values >0.050). A statistically significant difference was not found between the mean total RNFL thickness of the eyes that received injections and that of the eyes in the healthy control group (P value >0.050). A statistically significant difference was not found in all the treatment groups between the intraocular pressure level taken 1 day after the administration of the injections and that recorded preintervention (all P values >0.050).

Repeated IVR did not lead to a significant change in RNFL thickness in patients with nAMD.