Abstract
Purpose :
To evaluate the various patterns of subretinal fluid (SRF) in eyes with age related macular degeneration (AMD) in the absence of macular neovascularization (MNV), and to determine the future risk of macular atrophy.
Methods :
This retrospective study included only eyes with non-neovascular AMD and associated SRF. Eyes with evidence of MNV were excluded. Spectral domain optical coherence tomography (SD-OCT) was obtained at baseline and at follow up and qualitative and quantitative SD-OCT analysis of macular drusen including drusenoid pigment epithelial detachment (PED) and associated SRF was performed to determine anatomic outcomes.
Results :
Seventy-four eyes (74 patients) were included in this analysis. Mean duration of follow-up was 50.1±37.9 months. SRF exhibited 3 different morphologies: crest of fluid over the apex of the drusenoid PED, drape of low-lying fluid over confluent drusen or focus of fluid at the angle of confluent drusen. Forty-four (59.5%) of the 74 eyes with fluid displayed collapse of the associated druse or drusenoid PED and 33 (44.6%) of the 74 eyes developed evidence of complete retinal pigment epithelial and outer retinal atrophy (cRORA).
Conclusions :
Non-neovascular AMD with SRF is an important clinical entity to recognize to avoid unnecessary anti-VEGF therapy. In this entity, SRF may develop in association with drusen or drusenoid PED and in the absence of MNV and may be associated with the future development of atrophy, especially when the fluid is located over the apex of a drusenoid PED or drapes confluent drusen.
This is a 2020 ARVO Annual Meeting abstract.