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  • When Subretinal Fluid Persists in AMD

    By Jean Shaw
    Selected by Andrew P. Schachat, MD
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    Journal Highlights

    Ophthalmology Retina, October 2021

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    Core et al. assessed the presence of pre­dominantly persistent subretinal fluid (SRF) in eyes receiving ranibizumab or bevacizumab on a pro re nata basis for their age-related macular degeneration (AMD). They then compared the visual acuity (VA) of these eyes to that observed in eyes with nonpersistent SRF. They found that both sets of eyes had similar VA outcomes through two years of follow-up. Moreover, they found that, at the foveal center, persistent SRF was typically absent or present only in small quantities.

    For this secondary analysis of the CATT (Comparison of Age-Related Macular Degeneration Treatments Trials) study, reading center graders evaluated OCT scans at baseline and monthly follow-up visits for SRF. Predominantly persistent SRF through week 12 was defined as SRF at baseline and at weeks 4, 8, and 12. Predomi­nantly persistent SRF through years 1 or 2 was defined as SRF in 80% or more visits by those time points. The researchers used linear regression models to compare adjusted mean VA score and VA change from baseline in eyes with and without predominantly persistent SRF. The primary outcome measures were predominantly per­sistent SRF through year 1, adjusted VA score and VA change, and SRF thickness at the foveal center.

    Of 406 eyes with baseline SRF, fluid persisted in 108 eyes (26.6%) through week 12, in 94 eyes (23.2%) through year 1, and in 77 eyes (19%) through year 2. The adjusted VA score was simi­lar between eyes with and without per­sistent SRF at week 12, year 1, and year 2, as was adjusted change in VA. Among eyes with predominantly persistent SRF through year 1, fluid was absent in the foveal center in 46. In addition, thickness at the foveal center was 1 μm to 200 μm in 47 eyes and >200 μm in 1 eye at year 1.

    The lack of effect of persistent SRF on VA observed in this study may help explain why attempts to resolve persistent fluid in previous studies by switching from one anti-VEGF agent to another did not always result in im­provement in vision, the authors said.

    The original article can be found here.