Korean J Ophthalmol.  2020 Feb;34(1):11-18. 10.3341/kjo.2019.0081.

Changes in the Ganglion Cell-inner Plexiform Layer after Consecutive Intravitreal Injections of Anti-vascular Endothelial Growth Factor in Age-related Macular Degeneration Patients

  • 1Department of Ophthalmology and Inha Vision Science Laboratory, Inha University Hospital, Inha University School of Medicine, Incheon, Korea. hschin@inha.ac.kr


To investigate the effect of intravitreal anti-vascular endothelial growth factor (VEGF) injections on ganglion cell-inner plexiform layer (GCIPL) thickness in patients with age-related macular degeneration (AMD).
This retrospective study included patients with continuous anti-VEGF treatment who were administered at least three consecutive injections for unilateral neovascular AMD. The GCIPL thickness of the study eyes was compared before and after treatment and with healthy fellow eyes using spectral-domain optical coherence tomography. We also evaluated best-corrected visual acuity, age, and intraocular pressure.
In total, 96 eyes of 48 patients (14 females and 34 males; mean ± standard deviation [SD] age, 70.10 ± 8.89 years) with mean number of 6.29 (SD ± 3.76) anti-VEGF injections and a mean follow-up period of 24.93 months (SD ± 19.86) were included in the study. After three consecutive intravitreal injections of anti-VEGF, the mean GCIPL thickness was significantly reduced from 70.50 (SD ± 14.06) to 65.97 (SD ± 13.91) µm. Borderline or nonsignificant decrease was also observed in GCIPL thickness for each sector. At the end of the study, the mean GCIPL thickness was further reduced to 62.56 (SD ± 16.30) µm, and significant decreases were also observed in all other sectors compared with baseline.
It has been observed that GCIPL thickness can decrease with only three consecutive anti-VEGF injections as well as with long-term treatment in AMD patients.


Aflibercept; Anti-vascular endothelial growth factor; Ganglion cell-inner plexiform layer; Macular degeneration; Ranibizumab

MeSH Terms

Endothelial Growth Factors*
Follow-Up Studies
Ganglion Cysts*
Intraocular Pressure
Intravitreal Injections*
Macular Degeneration*
Retrospective Studies
Tomography, Optical Coherence
Visual Acuity
Endothelial Growth Factors


  • Fig. 1 Representative map of mean ganglion cell-inner plexiform layer (GCIPL) at baseline, after three consecutive monthly loading treatments with anti-vascular endothelial growth factor for neovascular age-related macular degeneration (posttreatment), and at study end (end of study). The graph shows that mean GCIPL thickness decreases from baseline to after loading treatment and then toward the end of the study. *p < 0.05.

  • Fig. 2 Case example of an age-related macular degeneration patient who was treated with anti-vascular endothelial growth factor therapy. A 60-year-old patient was administered three consecutive monthly intravitreal injections of aflibercept. A representative map of ganglion cell-inner plexiform layer thickness (A) at baseline and (B) after treatment. Each sectoral measurement of ganglion cell-inner plexiform layer thickness was also demonstrated (C) at baseline and (D) after treatment. OD = oculus dexter.


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