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. Issue 7 (July 2016)

• Record Type: Journal Article
• Authors: Wickremasinghe, Sanjeewa S.; Janakan, Vyshnavi; Sandhu, Sukhpal S.; Amirul-Islam, Fakir M.; Abedi, Farshad; Guymer, Robyn H.
• Is Part Of: Retina. Volume 36:Issue 7(2016:Jul.)
• Publication Date: 2016-07
• Subjects: 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); Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000000902
• Languages: English
• ISSNs: 0275-004X

Abstract

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. Abstract : There is poor correlation between visual acuity and the presence of fluid on optical coherence tomography, however new occurrence of fluid is more likely to lead to vision loss compared with absence or persistence of fluid. Factors other than fluid may also influence the visual outcome after antivascular endothelial growth factor treatment for neovascular age-related macular degeneration.