Implication of recurrent or retained fluid on optical coherence tomography for visual acuity during active treatment of neovascular age-related macular degeneration with a treat and extend protocol

Sanjeewa S. Wickremasinghe, Vyshnavi Janakan, Sukhpal S. Sandhu, Fakir M. Amirul-Islam, Farshad Abedi, Robyn H. Guymer

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13 Citations (Scopus)

Abstract

Purpose: Assess the correlation between optical coherence tomography findings and change in vision for patients receiving "treat and extend" protocol ranibizumab for neovascular age-related macular degeneration. Methods: Optical coherence tomography analysis and best-corrected visual acuity (BCVA) change: mild 5 to 9 letters, moderate 10 to 14 letters, and severe ≥15 letters. Results: A total of 103 eyes (99 patients, 63% female, 65-91 years) followed for 20.8 ± 4.9 months. By 12 months, there were 1.38 ± 0.59 instances of intraretinal fluid (IRF)/subretinal fluid recurrence on optical coherence tomography and 1.25 ± 1.00 instances of BCVA loss (≥5 letters) per patient. When BCVA was lost, IRF/subretinal fluid was present in 37.3% of cases. Occurrences of severe BCVA loss were less likely to recover vision than when BCVA loss was mild (5.9% vs. 75.6%, P 0.001). New occurrence of IRF (33.9%) or subretinal fluid (29.6%) was more likely to lead to BCVA loss, compared with dry (16.6%) or persistent IRF (11.9%) or persistent subretinal fluid (14%, P < 0.001). With persistent fluid, any new loss of vision had a lower chance of recovery than when fluid was new in onset (64.3% vs. 85.3%, P 0.04). Conclusion: During ranibizumab treatment, vision can decrease without signs of fluid. When fluid is present, IRF is associated with poorer vision. New occurrence of any fluid on optical coherence tomography is likely to lead to vision loss, but small amounts of persistent fluid can be tolerated without compromising vision.

Original languageEnglish
Pages (from-to)1331-1339
Number of pages9
JournalRetina: the Journal of Retinal and Vitreous Diseases
Volume36
Issue number7
DOIs
Publication statusPublished - Jul 2016
Externally publishedYes

Keywords

  • age-related macular degeneration (AMD)
  • antivascular endothelial growth factor (anti-VEGF)
  • choroidal neovascularisation (CNV)
  • intraretinal fluid (IRF)
  • optical coherence tomography (OCT)
  • ranibizumab
  • subretinal fluid (SRF)

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