Correlation Analysis between Optical Coherence Tomography Parameters of Neovascular Age-Related Macular Degeneration and Visual Prognosis at 2 Months after Anti-VEGF Therapy
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Objective To investigate the correlation between baseline optical coherence tomography (OCT) parameters and 2-month visual prognosis after anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with neovascular age-related macular degeneration (nAMD). Methods A retrospective analysis was performed on 100 nAMD patients treated with intravitreal anti-VEGF (bevacizumab, conbercept, or ranibizumab) at Puyang Eye Hospital (January 2020–June 2024). Based on 2-month best-corrected visual acuity (BCVA) changes, patients were classified into Good Prognosis (GP, n = 42) and Poor Prognosis (PP, n = 58) groups. OCT parameters (central macular thickness [CMT], subretinal fluid [SRF], hard exudates, etc.) were analyzed using chi-square test, Pearson correlation, ROC curve, and multivariate logistic regression. Results Baseline demographics showed no significant differences (P > 0.05). The PP group exhibited higher frequencies of retinal edema, hard exudates, cystic spaces, subretinal hyperreflective material (SHRM), hyperreflective foci, macular hemorrhage, SRF, RPE tear, and fibrosis (all P < 0.05). The GP group had higher baseline CMT (701.24 ± 556.13 µm vs. 474.34 ± 233.13 µm, P < 0.01). CMT correlated positively with postoperative logMAR BCVA (r = 0.496, P < 0.001) and showed moderate predictive value for prognosis (AUC = 0.707, cutoff = 538.5 µm, sensitivity = 76.2%, specificity = 70%). Multivariate analysis identified CMT as an independent protective factor (OR = 1.01, P < 0.001), while retinal edema, hard exudates, SHRM & ellipsoid zone (EZ) disruption, macular hemorrhage, and pigment epithelium detachment (PED) were risk factors. Conclusion Baseline OCT features are strongly associated with short-term visual outcomes in nAMD. CMT serves as an independent protective predictor, while edema, exudates, SHRM & EZ disruption, hemorrhage, and PED indicate poor prognosis.
