Evaluation of clinical findings affecting recurrence in cases with wet type age-related macular degeneration

Purpose: In this study, we aimed to investigate the clinical factors affecting recurrence in age-related macular degeneration (AMD) cases. Materials and Methods: Materials and Methods: In this study, the data of 193 AMD patients who applied the treat-and-extend (T&E) approach and applied to the Ophthalmology Clinic of Abant İzzet Baysal University İzzet Baysal Training and Research Hospital between June 2020 and May 2024 were retrospectively reviewed. The patients included in the study underwent a full ophthalmological examination. Age, gender, height, weight, body mass index, smoking and alcohol use status, lens status, systolic and diastolic blood pressure measurements, additional diseases, antiVEGF treatment used (aflibercept, ranibizumab), injection numbers, loading dose number, best corrected visual acuity (BCVA) information were obtained from file records and analyzed within the scope of the study. The presence of intraretinal fluid (IRF), subretinal fluid (SRF) and retinal pigment epithelial detachment (PED), CNV type, choroidal thickness, central retinal thickness (CRT), retinal nerve fiber layer thickness (RNFL), spectral domain optical coherence tomography (SD OCT) and medical records were obtained. Central corneal thickness (CCT), axial length (AL) measurements were obtained from the biometry device. Recent triglyceride, total cholesterol, fasting blood sugar (FBS), Hba1c, glucose, sedimentation, C-Reactive Protein (CRP), neutrophil/lymphocyte ratio values of the patients were obtained from the hospital information management system (KARMED). At the same time, loading dose injection numbers, loading dose date, recurrence numbers, recurrence date were determined from the hospital KARMED system. The relationship between basic clinical and systemic parameters was examined with Pearson correlation analysis. Findings: The study included 193 eyes of 193 patients who were receiving treatment for recurrent AMD and who had received at least 3 anti-VEGF loading doses. Of the patients included in the study, 83 were women and 110 were men. A low-moderate positive correlation (r=0.156, p=0.036) was found between CRT and ydObcva, and a negative correlation (r=-0.195, p=0.007) was found between IRF (Present/None) and the number of recurrences. Although approaching statistical significance, a weak positive correlation was found between the week of recurrence and MAP and EDI nasal data (p values were 0.057 and 0.051, r values were 0.238 and 0.146, respectively). In the linear regression analysis, the R square values of ftEDI, CRP, ydoBCVA, which were found to have a significant relationship with the recurrence week, were 0.093 and the adjusted R square values were 0.073. Conclusion: This study shows that IRF may be an indicator of response to anti-VEGF treatment and may play an important role in determining treatment strategies. It was also observed that factors such as age, body mass index (BMI), and central retinal thickness (CRT) may also affect the course of the disease. The results of the study emphasize that both ophthalmic and systemic factors should be carefully monitored due to the multifactorial structure of AMD. Key words: Age-Related Macular Degeneration, Optical coherence tomography, Treat and extend , Recurrence, Choroidal neovascularization