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2017 Agenda and Abstracts | < Previous Next >
2017 OMIG Abstract 7 In Vivo Confocal Microscopy of Human Corneal Nerves in Patients Receiving Intravitreal Anti-VEGF
Purpose: Vascular Endothelial Growth Factor (VEGF) is a trophic factor for corneal nerves (CN). Despite its wide-spread use to treat a variety of retinal diseases, the effect of repetitive intravitreal (IV) anti-VEGF injections on corneal nerves is not known. Methods: Retrospective study of 29 eyes with a history of IV injections compared to 79 control eyes. In a sub-analysis, 7 eyes served as their own controls. In vivo confocal microscopy (IVCM) examination was carried out using the 40X lens of the Confoscan 4. Images were analyzed by the Corneal Nerve Analysis tool (Nidek Technologies Srl, Padova, Italy). Independent and paired t test methodology was used to compare nerve parameters between case and control eyes. Multivariable linear regression analysis was performed to control for potential confounders. Results: Eyes receiving IV injections had significantly lower nerve densities (9415 µm/mm2 ±2816 vs 14254 µm/mm2 ±4331) and had lower numbers of fibers, trunks, bifurcations, and branches compared to those without a history of injection (p<0.05). When considering demographics and co-morbidities, age, diabetes, and IV injection remained significantly associated with nerve density, and explained approximately 47% of variability in the model (R=0.69). In a subgroup analysis of 7 patients who served as their own controls, the eyes with a history of IV injection had lower nerve length density (7207+-1607) compared to the fellow eyes without IV injection (10168±3511) and less branches (1.9±0.9 vs 3.4±1.7), but neither parameter reached statistical significance. Conclusion: We found decreased CN parameters in eyes with a history of IV anti-VEGF. Retina specialists should be aware of this observation and consider potential clinical effects including altered corneal sensitivity and wound healing. Disclosure: N
2017 Agenda and Abstracts | < Previous Next >
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