Older age and occult type choroidal neovascular membrane (CNV) are associated with non-response after anti-VEGF agent intravitreal injection in eyes with neovascular age-related macular degeneration (AMD).

1. Su Jeong Song¹
2. Hae Ran chang
3. Sung Woo Cho¹
3. Jung Hoon Bae¹

¹Department of Ophthalmology, Sungkyunkwan University School of Medicine,
Kangbuk Samsung Hospital, Seoul, Korea

Purpose: To describe frequency and characteristics of non-responder of intravitreal bevacizumab (IVB) in patients with neovascular age-related macular degeneration (AMD).

Methods: We retrospectively reviewed the records of 44 consecutive patients treated
with IVB and had at least a 6-month follow-up period. The non-responder was defined as followed. Eyes with no change of CNV lesion leakage in fluorescien angiography and minimal foveal thickness change (FTC<100㎛) in OCT after administration at least two times of IVB. Demographic findings and efficacy outcomes were compared between responder and non-responder based on patients' gender, age, visual acuity (VA), fovea thickness, CNV lesion type, CNV lesion size, presence of serous retinal detachment (SRD), presence of pigment epithelial detachment (PED), and presence of sub-macular hemorrhage (SMH).

Results: Seven patients (nine eyes) (19.2%) were identified as non-responder of treatment with IVB. Non-responder group was significantly older than responder group (p=0.022). Composition of CNV lesion type and presence of SRD were significantly different between responder and non-responder (p=0.002, p=0.013). All eyes of non-responder group had occult CNV. However, there was no significant difference in gender, baseline VA, baseline FT, CNV lesion size, presence of PED, and presence of SMH between two groups.

Conclusions: About 19.2% of neovascular AMD patients did not response to intravitreal bevacizumab injections in our study. Older age and occult type CNV can be predictive factors of response after IVB. Further studies are needed to identify non-responders of intravitreal anti-VEGF agents in neovascular AMD patients.