Abstract
Purpose :
This post-hoc analysis of the HARBOR trial in nAMD was conducted to determine if SRF resolution in eyes treated with ranibizumab had a concomitant deleterious effect on best-corrected visual acuity (BCVA).
Methods :
Eyes from the pooled arms of the HARBOR trial (NCT00891735) were included in the analysis if SRF, with or without intraretinal fluid (IRF), was present at baseline and fluid resolved during the course of the study, based on spectral-domain optical coherence tomography. Among those eyes that also had IRF present at baseline, IRF must have resolved at least one month prior to SRF resolution. Change in ETDRS BCVA was determined by comparing the BVCA in the month before SRF resolution with BCVA in the month SRF resolution was first detected. Patients who lost vision with SRF resolution, defined as a loss of ≥4 ETDRS letters, were compared with those who gained/maintained vision, defined as a loss of <4 ETDRS letters. Outcomes at M12 and 24 were analyzed in eyes with no SRF recurrence after going dry.
Results :
Three hundred and forty-nine eyes met inclusion criteria. Mean time to first detection of SRF resolution was 2.3 months. Between the month prior to dry and the month of SRF resolution, 11% (38/349) lost ≥4 ETDRS letters (mean -9.0 letters [-10.9, -7.1]) and 89% (311/349) of eyes gained/maintained BCVA (mean 6.3 letters [5.5, 7.0]; Table 1). Among eyes that had no SRF recurrence after going dry, those that lost ≥4 ETDRS letters, compared to those that maintained/gained, at the time of SRF resolution had reduced visual outcome gains from baseline at M12 (1.8 vs 13.1 letters) and M24 (0.5 vs 12.8 letters; Table 2). Once dry, there was little difference between groups in the BCVA gained from the month first dry to M12 or M24 (7.2 vs 4.2 and 5.8 vs 4.0 letters, respectively).
Conclusions :
Eleven percent of eyes lost BCVA at the time of SRF resolution, and these eyes had reduced long-term visual outcomes at M12 and M24. Loss of ≥4 ETDRS letters at the time of SRF resolution may portend worse long-term visual outcomes. Treating eyes to SRF resolution may be deleterious in some. Further studies are warranted.
This is a 2021 ARVO Annual Meeting abstract.