Foveal threshold and photoreceptor integrity for prediction of visual acuity after intravitreal aflibercept on age-related macular degeneration

PURPOSE: To determine whether baseline foveal threshold and photoreceptor integrity can predict best-corrected visual acuity (BCVA) at 12 months after intravitreal aflibercept (IVA) therapy in eyes with neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: We evaluated 25 eyes of 25 patients with treatment-naïve neovascular AMD who received IVA once a month for 3 months, followed by once every 2 months for 8 months. BCVA, integrity of the external limiting membrane (ELM) or the ellipsoid zone (EZ) of the photoreceptors, and retinal sensitivity were determined before (baseline) and at 6 and 12 months after initial IVA. The average threshold foveal sensitivity and mean deviation within the central 10° were determined by Humphrey central 10-2 perimetry. Correlations between BCVA at 12 months and integrity of the ELM or EZ, foveal threshold, and mean deviation at each visit were determined. RESULTS: At 12 months, BCVA improved significantly from 0.20±0.23 to 0.10±0.22 logMAR (logarithm of the minimum angle of resolution) units, and foveal threshold and mean deviation improved significantly from 29.0±5.1 and −3.38±3.10 dB to 32.6±3.2 and −1.64±2.10 dB, respectively (P=0.0009 and P=0.0021). At baseline, both foveal threshold and integrity of the ELM were significantly correlated with BCVA at 12 months (P=0.0428 and P=0.0275). CONCLUSION: These results indicate that both integrity of the ELM and foveal threshold at baseline can predict BCVA after treatment for neovascular AMD. There is a possibility that these parameters can predict the efficacy of IVA in each case.