Fibrosis in Patients With Choroidal Neovascularization Based on Spectral-Domain Optical Coherence Tomography:...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Imaging

Background:

• Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss.
• Choroidal neovascularization (CNV) is a hallmark of nAMD.
• Fibrosis development in nAMD can impact visual outcomes.

Purpose of the Study:

• To determine the incidence and impact of fibrosis on visual acuity in nAMD patients.
• To analyze fibrosis rates based on different choroidal neovascularization (CNV) types.
• To assess the influence of fibrosis on visual outcomes in nAMD.

Main Methods:

• Utilized data from the HARBOR trial (NCT00891735) involving 1097 nAMD patients.
• Assessed fibrosis status and location at 24 months, stratified by baseline CNV type.
• Patients received either pro re nata or monthly ranibizumab treatment.

Main Results:

• Fibrosis was most prevalent in type 2 CNV lesions (53%) compared to other types.
• Subretinal fibrosis frequently involved the subfoveal area (65%–78%) at 24 months.
• Mean visual acuity gains at 24 months were not negatively impacted by fibrosis, irrespective of CNV type or treatment regimen. Male sex and smoking were associated with higher fibrosis rates.

Conclusions:

• Fibrosis develops in a significant proportion of nAMD patients despite anti-VEGF therapy.
• The prevalence of fibrosis is significantly influenced by the baseline CNV type.
• Fibrosis does not preclude visual acuity improvement in nAMD patients treated with ranibizumab.