Abstract

We evaluated the impact of macular fluid features on visual and anatomical outcomes in type 3 macular neovascularization (MNV) patients treated with anti-vascular endothelial growth factor (VEGF). We retrospectively enrolled 89 eyes with type 3 MNV with at least 12 months of follow-up. All patients were treatment-naïve and received a monthly loading injection of anti-VEGF for three months, followed by further injections as required. The association of baseline macular morphology, including intraretinal fluid (IRF) and subretinal fluid (SRF), with visual and anatomical outcomes was analyzed. At baseline, IRF was present in all enrolled patients (100%), and SRF was present in 43.8% (39/89) of them. After 12 months of treatment, no significant difference was found in terms of best-corrected visual acuity (BCVA) and changes in central foveal thickness between the eyes with (39) and without (50) SRF at baseline. In addition, the proportion of improved or worsened (gain or loss of more than three lines in the BCVA) visual acuity at 12 months was not significantly different among the groups. Incidence of macular atrophy during the treatment showed no difference between the groups, regardless of the presence of SRF. In conclusion, the macular fluid morphology, specifically SRF, in type 3 MNV showed no significant correlation with visual and anatomical outcomes during anti-VEGF treatment.

Highlights

  • We evaluated the impact of macular fluid features on visual and anatomical outcomes in type 3 macular neovascularization (MNV) patients treated with anti-vascular endothelial growth factor (VEGF)

  • Post-hoc analyses of multiple major clinical trials including the Comparison of Age-Related Macular Degeneration Treatments (CATT) T­ rials[7] and VEGF Trap-Eye: Investigation of Efficacy and Safety in Wet age-related macular degeneration (AMD) (VIEW 2) ­trial[8] have shown that intraretinal fluid (IRF) is associated with lower baseline visual acuity (VA) and worse visual outcomes when compared with subretinal fluid (SRF)[7,8]

  • IRF was present in all enrolled subjects (100%), and SRF was present in 43.8% (39/89) of them

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Summary

Introduction

We evaluated the impact of macular fluid features on visual and anatomical outcomes in type 3 macular neovascularization (MNV) patients treated with anti-vascular endothelial growth factor (VEGF). The association of baseline macular morphology, including intraretinal fluid (IRF) and subretinal fluid (SRF), with visual and anatomical outcomes was analyzed. The macular fluid morphology, SRF, in type 3 MNV showed no significant correlation with visual and anatomical outcomes during anti-VEGF treatment. Post-hoc analyses of multiple major clinical trials including the Comparison of Age-Related Macular Degeneration Treatments (CATT) T­ rials[7] and VEGF Trap-Eye: Investigation of Efficacy and Safety in Wet AMD (VIEW 2) ­trial[8] have shown that intraretinal fluid (IRF) is associated with lower baseline visual acuity (VA) and worse visual outcomes when compared with subretinal fluid (SRF)[7,8]. It is well known that fluid types at presentation are associated with visual outcomes after antiVEGF treatment in neovascular AMD, the prognostic implications of fluid types in type 3 MNV have not been

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