Parámetros tomográficos como factores pronóstico del resultado visual tras terapia con ranibizumab en degeneración macular neovascular asociada a la edad

Résumé

Objective To evaluate macular morphological parameters measured by spectral domain optical coherence tomography (SD-OCT) as predictive factors of visual outcome in patients with exudative age-related macular degeneration (AMD) treated with ranibizumab. Methods A retrospective study was conducted on 47 patients diagnosed with exudative AMD and treated with intravitreal ranibizumab for twelve months. Central retinal thickness (CRT), extension and thickness of modifications secondary to neovascular process, and status of the bands corresponding to the external limiting membrane (ELM) and to the ellipsoid region of the photoreceptors (ISe) were evaluated by means of SD-OCT. The relationship between these variables and visual acuity was analyzed by statistical methods. Results At the time of the diagnosis, preservation of ELM and ISe bands, and CRT were correlated with initial visual acuity. Twelve months later, CRT and visual acuity were independent parameters. Bivariate relationship analysis showed a correlation between final visual acuity and the following parameters: initial CRT, initial ISe and ELM status, and ISe and ELM integrity after loading dose. Multiple regression analysis indicated that initial visual acuity and ISe band status after loading dose have a predictive value for final visual acuity. Conclusions The status of ISe and ELM bands after twelve months of treatment with ranibizumab was associated with visual outcome. Initial visual acuity and status of the ISe band after loading dose are prognostic factors of final visual acuity.