Baseline OCT Predicts Wet AMD Prognosis and Treatment Response

Tailoring anti-VEGF regimens based on these baseline OCT features may improve patient outcomes. Photo: Carolyn Majcher, OD. Click image to enlarge. Treating wet age-related macular degeneration (AMD) is a long process involving frequent and costly anti-VEGF injections. Appropriate treatment plans are devised based on a patient’s response to therapy, which is typically assessed using OCT and visual acuity testing. A new study suggests that clinicians may be able to evaluate treatment efficacy much earlier than previously thought, allowing for more timely intervention and tailored treatment plans that could save patients both time and money. The BMC Ophthalmology paper identified morphologic features on OCT influencing the effectiveness of anti-VEGF injections.Researchers in Beijing analyzed 251 wet AMD eyes that received anti-VEGF therapy for one to three months. They obtained OCTs at baseline, one month and three months, and defined treatment effectiveness as ≥25% reduction in central retinal thickness or absence of subretinal and intraretinal fluids after treatment.They found that after one injection, treatment responders had smaller baseline lesion sizes, lower pigment epithelial detachment height and larger baseline intraretinal fluid compared to non-responders. After three injections, treatment responders also showed larger baseline intraretinal fluid.Multivariate analysis showed that greater central retinal thickness reductions at one and three months were linked to larger baseline central retinal thickness, larger baseline intraretinal fluid and lack of retinal hemorrhage. “For patients with retinal hemorrhage, anti-VEGF treatment alone may be insufficient,” the researchers wrote in their paper.Based on these findings, the researchers concluded that “baseline OCT features significantly influence treatment responsiveness in wet AMD.” OCT characteristics linked to treatment outcomes were almost identical at one and three months post-treatment, suggesting that improvement at one month could predict long-term treatment response.Click here for the journal source. Rao T, Yang J, Chen J, et al. OCT-based morphological prognostic factors for structural improvement after anti-VEGF therapy and wet age-related macular degeneration. BMC Ophthalmol 2026. [In Press]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.