Abstract
Purpose :
To determine the effect of persistent subretinal fluid (SRF) relative to resolved SRF on long-term visual acuity in eyes treated with ranibizumab or bevacizumab for neovascular age-related macular degeneration (nAMD) in the CATT.
Methods :
Secondary analysis of CATT data from eyes with SRF at baseline and were treated pro re nata (PRN) for 2 yrs. OCT imaging was every 4 wks. Treatment was based on signs of active nAMD. Certified readers at the CATT reading center assessed OCT scans for macular presence and foveal thickness of SRF. Persistent SRF at wk 12 was defined as SRF present at wks 4, 8, and 12, while persistent SRF at 1 or 2 yrs was defined as SRF present at ≥80% of visits over the 1- or 2-yr period. Mean visual acuity (VA) score and mean VA gain from baseline at 1 or 2 yrs were compared between eyes with vs. without persistent SRF using regression models that adjusted for persistent intraretinal fluid (IRF) and previously reported baseline VA predictors in CATT.
Results :
Among 406 eyes with baseline SRF, 26.6% had persistent SRF at wk 12, 23.2% at yr 1, and 19.0% at yr 2. Eyes with vs. without persistent SRF at wk 12 showed similar mean VA score (letters) at yr 1 (68.3 vs. 69.9; p=0.29) and yr 2 (69.0 vs. 68.8; p=0.93), and similar VA gain at yr 1 (6.1 vs. 7.3; p=0.30) and year 2 (6.6 vs. 6.4; p=0.94) (Table 1). Yr 1 persistent SRF compared with no persistent SRF was not associated with significantly different mean VA scores at yr 1 (67.6 vs. 70.1; p=0.12) and yr 2 (68.5 vs. 69.0; p=0.77), or VA gain at yr 1 (5.2 vs. 7.8; p=0.10) and yr 2 (6.0 vs. 6.6; p=0.74). Yr 2 persistent SRF compared to no persistent SRF was not associated with significantly different mean VA scores at yr 1 (71.4 vs. 70.8; p=0.71) and yr 2 (70.0 vs. 69.5; p=0.80) or VA gain at yr 1 (7.9 vs. 7.8; p=0.92) and yr 2 (6.5 vs. 6.5; p=0.97). At yr 1 and earlier timepoints, SRF was absent at the foveal center in nearly half of eyes with yr 1 persistent SRF, and <200 µm thick among most others (Table 2).
Conclusions :
Among eyes with baseline SRF, mean VA in eyes with persistent SRF through 12 wks, 1 yr, or 2 yrs of PRN treatment was similar to eyes in which SRF resolved. Persistent SRF >200 µm thick at the foveal center was rare.
This is a 2021 ARVO Annual Meeting abstract.