Time course of morphologic effects on different retinal compartments after ranibizumab therapy in age-related macular degeneration

PURPOSE: To analyze the effect of ranibizumab therapy on retinal and subretinal compartments in age-related macular degeneration and to compare the time course of compartment specific effects to visual function. DESIGN: Prospective noncomparative case series. PARTICIPANTS: Fourteen patients with changes in 3 major compartments owing to neovascular age-related macular degeneration. METHODS: Standard treatment with 3 monthly doses of intravitreal ranibizumab was performed. Eyes were examined at baseline and weeks 1, 4, and 12 using a standardized protocol. Manual segmentation was applied to all 128 B-scans contained in a macular raster scan (MRS). MAIN OUTCOME MEASURES: Morphology and time course of different retinal and subretinal compartments. RESULTS: High-definition optical coherence tomography and manual segmentation allowed for precise identification of volumes within individual compartments. All morphologic parameters responded positively to therapy, but demonstrated a specific time course. Subretinal fluid was identified as the most relevant factor for visual function, whereas changes in retinal and subpigment epithelial volumes did not correlate with the time course of functional rehabilitation. CONCLUSION: Analysis of MRS identified a characteristic impact of therapy on retinal and subretinal morphology.