Serous Detachment Research Articles

Choroidal osteoma: a rare clinical picture

Choroidal osteoma is a rare benign bone tumor. It is unilateral in two thirds of cases. It occurs unilaterally and more often in young women. The tumor is most often located near the papilla. The complications classically described are progressive retinal atrophy and choroidal neovascularization. We report the case of a 39-year-old female patient, with no previous history, who consulted us for a sudden unilateral decrease in visual acuity, associated with metamorphopsias and a para-central scotoma. Fundus examination of the right eye revealed a large, yellowish-white choroidal tumor with fairly well-delineated margins in a juxta-papillary arrangement. Fluorescein angiography showed an early hyperfluorescence becoming intense at late times, associated with papillary edema. In front of this picture, we evoke the hypothesis of a choroidal neovascular membrane. The optical coherence tomography (OCT) showed the presence of a hyper-reflective pre-epithelial lesion in the inter-papillomacular region, associated with a retinal serous detachment, indicating a choroidal neovascular complication. B-mode ultrasonography confirmed the diagnosis by showing a hyperechoic thickening of the choroid with a posterior shadow cone. In our case, it was a choroidal osteoma complicated by optic neuropathy and choroidal neovascularization. The patient received several intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF), followed by long-term monitoring. Choroidal osteoma is a rare benign tumor. It often progresses slowly, but may have complications, in particular choroidal neovascularization, the treatment of which is not well codified. The long-term visual acuity is often very poor.

Polypoidal Choroidal Vasculopathy Mimicking as Central Serous Chorioretinopathy

Polypoidal choroidal vasculopathy (PCV) is considered one of the disease entities in the pachychoroid spectrum sharing the common finding of abnormally thickened choroid with Central serous chorioretinopathy (CSCR). Polypoidal choroidal vasculopathy (PCV) is a vascular malformation of the choroid, comprising a network of branching vessels of varying sizes that produce aneurysmal-like enlargements. This disease is generally observed in the macular area. Central serous chorioretinopathy is a retinal disorder characterized by localized serous detachment of the macula. It is secondary to retinal pigment epithelial decomposition and choroidal vascular changes. Fundus photography, optical coherence tomography (OCT), Fundus fluorescein angiography, and Indocyanine green angiography (ICG) aid in the diagnosis and differentiation between these two entities. Here, we report a case of middle aged female presented initially with clinical features suggestive of CSCR and later turned out to be a case of PCV.

Central Serous Chorioretinopathy in Course of Polycystic Ovary Syndrome - Literature Review

Central serous chorioretinopathy (CSCR) is one of several retinal disorders that may cause visual loss. It is characterized by serous detachment of the neurosensory retina, often associated with focal detachments of an altered retinal pigment epithelium, mostly confined to the macular area. As CSCR is considered to be correlated with an increased level of testosterone, it was of the interest if it is also linked to the occurrence of polycystic ovary syndrome (PCOS).

Response to brolucizumab treatment for refractory serous pigment epithelial detachment secondary to polypoidal choroidal vasculopathy

PurposeTo report the efficacy and safety of brolucizumab in the treatment of refractory serous pigment epithelial detachment (PED) secondary to polypoidal choroidal vasculopathy (PCV).MethodsTwenty-six eyes of 26 patients were included. Intravitreal brolucizumab 6.0 mg was administered, followed by pro re nata (PRN) retreatment at monthly follow-ups. All patients underwent spectralis domain optical coherence tomography (SD-OCT), fluorescein angiography, and indocyanine green angiography before the first brolucizumab injection. SD-OCT was repeated at follow-up visits. The height and width of the serous PEDs, measured using SD-OCT, were analyzed.ResultsThe number of previous anti-VEGF injections was 12.3 ± 15.0. During brolucizumab treatment, anatomical improvement was achieved and maintained in the height and width of the PEDs (p < 0.05). However, the visual outcome did not improve significantly (p > 0.05). A good response was achieved in 69.2% of eyes at 1 month and at the last visit. Relapse and complete resolution were observed in 27.8 and 23.1% of patients, respectively. The number of brolucizumab injections was 2.00 ± 0.85. Intraocular inflammation, vascular obstruction, and retinal pigment epithelial tears were not observed.ConclusionIntravitreal brolucizumab may be an effective and safe treatment option for refractory serous PEDs in patients with PCV.

Surgical management of disc pit maculopathy: A case report

AbstractPurpose: Optic disc pit (ODP) is a rare congenital disorder that affects one in 10 000 people. Serous detachment of macula is the most common complication and the natural history of untreated ODP maculopathy is a gradual deterioration with significant visual loss. A multitude of interventions have been designed for the treatment but none has been established as the treatment of choice. Pars plana vitrectomy is one of the most commonly used procedure in recent years. We present a case report with surgical treatment and management of complications.Methods: An interventional case report of a 63‐year‐old man who attended the emergency room due to sudden visual loss and best corrected visual acuity (BCVA) of 20/200 in the right eye (RE). Upon his arrival, a visual field was performed in which complete abolition of the right field was observed, severely affecting the central area. A papillary pit was found in the eye fundus. Optical coherence tomography (OCT) revealed a serous retinal detachment (RD) with macular involvement and surgical management was decided.Results: A successful pars plana vitrectomy (PPV) with peeling of the internal limiting membrane and application of an endolaser was performed. Three months later, he came back with a higher serous RD and a worsening of BCVA. We performed a second PPV with sulfur hexafluoride (SF6) with good anatomical results. One year later, cataract and an inferior rhegmatogenous retinal detachment with proliferative vitreoretinopathy (PVR) was treated with intraocular lens implantation and PPV with silicone oil. Five months later, supero‐temporal retina was detached, so a new PPV was carried out with silicone oil again. One year later, the silicone oil was removed and a retinal detachment was noted 3 months later. Finally, the last surgery was performed practicing encircling band, PPV, application of endolaser and again using silicone oil.Conclusions: Surgical management of serous retinal detachment caused by papillary pit continues being a challenge for retinal specialists. Complications of surgery are no usually publish in literature and this case report make us take into account. Since it ranges from observation to surgical approach using different techniques and procedures without any showing clear superiority.

Optic disc pit macular serous detachment recurrence. A surgical approach using ILM autograph

AbstractPurpose: We aim to present a surgical approach for optic disc pit macular serous detachment recurrence, using pars plana vitrectomy (PPV) and internal limiting membrane (ILM) autograft.Methods: Case report – Description of the surgical technique and presentation of the outcome.Results: A 55 year‐old female patient referred to our clinic's Vitreoretinal Department complained of reduced visual acuity at the right eye. On clinical examination, optic disc pit, cystic maculopathy and serous detachment were noted. The patient reported a history of vitrectomy for optic pit macular detachment on the same eye 25 years ago. To manage the recurrent macular detachment, she underwent a vitrectomy, during which the ILM was removed, and part of it used as an autograft on the optic disc pit. Mild endophotocoagulation on the area of the maculopapular bundle was performed, and gas endotamponade was utilized. On follow‐up examinations, a continuous improvement in serous detachment and visual acuity was noted.Conclusions: In cases with recurrent macular serous detachment due to optic disc pit maculopathy, PPV combined with ILM autograft, endophotocoagulation and gas tamponade seems to be a promising technique with satisfactory anatomical and functional improvement.

Retinal pigment epithelial (RPE) tears after serous pigment epithelial detachment (PED) in wet AMD: A retrospective study of 23 patients

AbstractPurpose: Age‐related macular degeneration (AMD) is one of the main causes for vision impairment. Pigment epithelial detachment (PED) is a common finding, which in its serous form is associated with wet AMD. PED can lead to retinal pigment epithelial (RPE) tears, which are associated with a further loss in vision. One known risk factor for RPE ruptures is the use of anti‐VEGF injections in patients with persisting PED. The aim of our study was to identify morphological parameters in the SD‐OCT that could present risk factors for RPE tears. Furthermore, this study aims at helping to predict functional and morphological outcomes for patients with RPE tears associated with PED in AMD.Methods: All patients in the database of Vista Augenklinik Binningen, Switzerland, diagnosed with RPE tears in SD‐OCT were included. Patients who presented with RPE tears at their first consultation were excluded from the study. Both morphological factors in imaging (SD‐OCT, FAF), as well as the history of anti‐VEGF injections prior and after the RPE tears occurred, were retrospectively analysed.Results: 23 eyes of 23 patients (57% females) were included. At the time of the RPE tear, the mean age was 81.9 ± 13.1 years (range: 70–95 years, median: 83 years). Mean follow‐up time was 28.7 ± 31 months (range: 1–52 months) after the rupture. The mean height of PED was 324.5 μm (range: 24‐837 μm) at the first consultation. In 6 out of 7 patients (86%) with initial PED height &gt; 526 μm, an RPE rupture occurred between the first and second consultation. 4 out of those 6 patients (67%) had received their first anti‐VEGF injection. Only 2 out of the other 16 patients (12%) with PED ≤375 μm had a rupture between the first and second consultation. The mean PED height in the last OCT imaging before rupture was 563 ± 486.55 μm (range: 121‐1039 μm). 8 patients (35%) had received exactly one anti‐VEGF injection before the rupture (mean height before rupture: 580,5 μm), another 8 patients (35%) received more than one injection (range: 2–55, mean height before rupture: 589,1 μm) and 7 patients (30%) did not receive anti‐VEGF injections (mean height before rupture: 513.1 μm).Conclusions: The risk of RPE tears should be considered when treating patients with PED in wet AMD. Further studies with larger sample sizes should be encouraged in addition to the existing scores.

Multiple sclerosis and occlusive retinal vasculitis: A case series

AbstractPurpose: Retinal vascular changes are a common finding in patients with multiple sclerosis (MS). While simple peripheral retinal periphlebitis is by far the most frequent manifestation, a spectrum exists that ranges up to the presence of proliferative retinal vasculitis.Methods: Case series of four patients with occlusive retinal vasculitis.Results: Three patients presented with complaints of visual loss and ocular discomfort: a 26‐year‐old man presented with vitreous inflammation, vitreous haemorrhage, macular edema and papillitis; a 44‐year‐old woman presented with intermediate uveitis and macular edema; and a 25‐year‐old woman presented with granulomatous panuveitis, papillitis and foveolar serous detachment. A fourth patient was addressed because of abnormal eye movements detected during a work‐up for dizziness. Examination revealed bilateral internuclear ophthalmoplegia with adduction lag. He had no visual complaints other than subtle floaters in the left eye. Anterior segment examination showed no signs of inflammation, whereas vitreous snowballs were present. Fluorescein angiography revealed occlusive retinal vasculitis in all patients, resulting in active neovascularization in two patients with vitreous haemorrhage in one of them. All patients required retinal laser photocoagulation. Extensive work‐up revealed multiple sclerosis as the underlying disease in three patients; the remaining patient had already been diagnosed with MS at the time of presentation. Nevertheless, additional work‐up was performed in this patient to exclude other possible causes.Conclusions: Occlusive retinal vasculitis is a rare manifestation in patients with MS and may result in neovascularization, vitreous haemorrhage, retinal detachment and neovascular glaucoma. MS should therefore be considered in the differential diagnosis of ischemic retinal disease. In addition, one should be alert for signs of retinal vasculitis in patients with MS, as it can present with few or no symptoms.

Efficacy and safety of brolucizumab for serous drusenoid pigment epithelium detachment non-responder to bevacizumab and aflibercept.

We report the case of a woman with drusenoid pigment epithelial detachment (DPED) in age-related macular degeneration who was successfully treated with two monthly intravitreal injections of brolucizumab after failing to respond to previous intravitreal injections of bevacizumab and aflibercept. A 56-year-old woman with mixed DPED and overlying subretinal fluid in her right eye was initially treated with three intravitreal injections of bevacizumab and three intravitreal injections of aflibercept with no visual and anatomical improvement. Switching to intravitreal injection of brolucizumab was performed. After two consecutive monthly intravitreal injections of brolucizumab, optical coherence tomography (OCT) showed first subretinal fluid resolution and then DPED collapse in the following months. After nine months, the best corrected visual acuity had improved from 20/40 to 20/20. There were no signs of retinal atrophy and exudative activity on OCT examination. No serious or minor adverse events were reported during the follow-up period. Switching to intravitreal brolucizumab injection might be an effective therapeutic option for treatment of mixed DPED with subretinal fluid refractory to other anti-VEGF drugs.

DeepPDT-Net: predicting the outcome of photodynamic therapy for chronic central serous chorioretinopathy using two-stage multimodal transfer learning

Central serous chorioretinopathy (CSC), characterized by serous detachment of the macular retina, can cause permanent vision loss in the chronic course. Chronic CSC is generally treated with photodynamic therapy (PDT), which is costly and quite invasive, and the results are unpredictable. In a retrospective case–control study design, we developed a two-stage deep learning model to predict 1-year outcome of PDT using initial multimodal clinical data. The training dataset included 166 eyes with chronic CSC and an additional learning dataset containing 745 healthy control eyes. A pre-trained ResNet50-based convolutional neural network was first trained with normal fundus photographs (FPs) to detect CSC and then adapted to predict CSC treatability through transfer learning. The domain-specific ResNet50 successfully predicted treatable and refractory CSC (accuracy, 83.9%). Then other multimodal clinical data were integrated with the FP deep features using XGBoost.The final combined model (DeepPDT-Net) outperformed the domain-specific ResNet50 (accuracy, 88.0%). The FP deep features had the greatest impact on DeepPDT-Net performance, followed by central foveal thickness and age. In conclusion, DeepPDT-Net could solve the PDT outcome prediction task challenging even to retinal specialists. This two-stage strategy, adopting transfer learning and concatenating multimodal data, can overcome the clinical prediction obstacles arising from insufficient datasets.

Predictive impact of optical coherence tomography biomarkers in anti-vascular endothelial growth factor resistant macular edema treated with dexamethasone implant

PurposeTo perform a longitudinal analysis of the effect of optic coherence tomography (OCT) biomarkers on macular thickness in patients with persistent macular edema secondary to diabetes mellitus and retinal vein occlusion who recieved intravitreal dexamethasone (DEX) implant. MethodsEighty-nine patients were included in the retrospective study. Patients with anti-VEGF-resistant macular edema were included in the study. The effect of the presence or absence of OCT biomarkers before intravitreal DEX implant therapy on central foveal thickness (CFT) was evaluated. In addition, the change in biomarkers from the baseline visit to the final visit was evaluated. The evaluated OCT biomarkers were as follows: ellipsoid zone and external limiting membrane (ELM) integrity, hyperreflective foci (HRF), disorganization of inner retinal layers (DRIL), hard exudates, serous macular detachment (SMD), pearl necklace, posterior vitreous detachment and the epiretinal membrane (ERM). ResultsThe mean age of the overall sample in the study was 64.4 ± 9.6. CFT decreased significantly from 625.3 ± 22.3 μm at baseline to 365.0 ± 21.7 μm in the 1st month but increased significantly to 430.2 ± 22.6 μm in the 3rd month. In the presence of HRF and SMD, recurrence of macular edema was significant in the 3rd month. The percentage of ELM disruption, DRIL, and ERM deteriorated significantly and the percentage of SMD improved significantly at the final visit. ConclusionsDEX implant therapy resulted in a satisfactory reduction in CFT in patients with DME and RVO. The presence of HRF and SMD is a negative predictor of recurrence in CFT in short term. DEX implant therapy resulted in satisfactory improvement in SMD.

Differential diagnostics of incomplete Vogt-Koyanagi-Harada syndrome (clinical case)

Introduction. According to literature sources, choroidal detachment is considered mainly as a complication of surgical treatment. At the same time, bilateral choroidal detachments in combination with retinal detachment are extremely rare. Spontaneous bilateral detachments are mentioned even less frequently. Purpose: To describe and analyze a clinical case of spontaneous bilateral subtotal detachment of choroid, to differentiate the diagnosis. Materials and methods. A 62-year-old patient was urgently hospitalized to the neurological department of Bor Central Clinical Hospital with complaints of severe headache accompanied by repeated vomiting. The computer tomography of brain, B-scanning, optical coherence tomogram were performed. There were ultrasonic results on the next day after the hospitalization: bilateral subtotal detachment of choroid, IOP = 10-11 mm Hg. Results. At the release: A slight local flat choroidal detachment was observed, OD profile of the retina was without pathology, partial detachment of the hyaloid membrane and vitreous body, OS retinal profile was a serous detachment of the neuroepithelium in the macular region. The decreased vision in both eyes was observed at the control examination two months later. The cystic macular edema of both eyes and progression cataract were diagnosed.

Features of the postoperative period after glaucoma surgery in a patient with Sturge-Weber syndrome (clinical case)

PURPOSE. To evaluate the effectiveness of surgical treatment of secondary glaucoma and to present the clinical features of the postoperative period in a patient with Sturge-Weber syndrome (SWS). METHODS. A patient with SWS, choroidal hemangioma and secondary glaucoma was examined and treated (Ahmed valve implantation) at the S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery" in Moscow. RESULTS. Hypotension, a decrease in anterior chamber depth, serous choroidal detachment were observed on the first day after surgery on the left eye. Posterior scleral trepanation and injection of viscoelastic into the anterior chamber was performed. On the next day, IOP normalization and complete choroidal attachment were achieved, but macular detachment of neuroepithelium occurred and was successfully treated with injections of glucocorticosteroids. After one month, the retina and choroid were attached, IOP was 16 mm Hg in the left eye without hypotensive drops, visual acuity was 1.0 in both eyes. CONCLUSION. Implantation of the Ahmed valve can be used in the treatment of secondary glaucoma in patients with SWS in order to reduce the IOP and minimize the risks of complications.

A Review of Central Serous Chorioretinopathy: Clinical Presentation and Management.

Central serous chorioretinopathy (CSC) may be understood as a disease of the chorioretina with the serous detachment of the neurosensory retina, which is secondary to single or multiple localized defects in retinal pigment epithelium (RPE). CSC is one of the common forms of loss of vision, usually seen in people who do belong to the working-age group. The most common symptoms are blurring of vision, usually unilateral and which is perceived as a scotoma in the center of the field of vision with associated metamorphopsia and micropsia. The risk factor associated with CSC is psychosocial stress, type A personality, pregnancy, and hypercortisolism. Normal vision is often restored within a span of a few months. After around three months, if the resolution of acute CSC did not change or, let us say, in the case of CSC that is chronic, one should consider treatment. In acute CSC, to resolve symptoms, especially in individuals who work in a field where eyesight is of utmost importance, for example, pilots, focal photocoagulation of leaking RPE lesions can be performed. CSC is a prototype cause of serous neuroretinal detachment, which involves the fovea. CSC symptoms reflect the separation between the RPE and the photoreceptors and the bullous distension of the foveal retina. The effect of therapy as such on the long-term outcome of vision visual is not sufficiently documented. The management would largely be dependent on the appropriate diagnosis made based on clinical presentations, and thus it becomes very much necessary to have knowledge about the same and counsel the patient regarding the association between stress and disease pathology. In acute CSC, retinal photocoagulation is successful to a good extent in eliminating or reducing the leakage of RPE and hence it induces resolution of the serous detachment. This review article is made to make sure the reader is updated about the various clinical and management aspects of CSC by providing a comprehensive idea that is obtained from various well-acknowledged databases across the globe on CSC.

Prevalence of Serous Macular Detachment in Recurrent Macular Edema Secondary to Retinal Vein Occlusion.

Objectives:To evaluate the prevalence of serous macular detachment (SMD) accompanying recurrent cystoid macular edema (CME) in patients initially treated for CME secondary to retinal vein occlusion (RVO) with accompanying SMD, and discuss the factors that affect the prevalence.Materials and Methods:We retrospectively evaluated the medical records of 71 patients with RVO-associated CME and SMD who achieved complete anatomical resolution after treatment with either a single dexamethasone implant or three loading doses of ranibizumab and developed recurrent CME during follow-up.Results:Initial treatment was a single intravitreal dexamethasone implant in 45 patients (63.4%) (Group 1) and three loading doses of intravitreal ranibizumab in 26 patients (36.6%) (Group 2). The mean time to CME recurrence was 4.7±0.8 months (range, 4-7 months) and was similar in both groups (p=0.984). At the time of CME recurrence, SMD was present in 41 patients (57.7%) and absent in 30 patients (42.3%). SMD was present in 27 (60.0%) of the 45 Group 1 patients and 14 (53.8%) of the 26 Group 2 patients (p=0.613). SMD was present in 48.8% of branch RVO and 71.4% of central RVO patients at the time of recurrence (p<0.001).Conclusion:SMD accompanied recurrent CME in only 57.7% of patients previously treated for CME and SMD and seems to be more frequent in patients with central RVO. Initial intravitreal treatment choice of either ranibizumab or dexamethasone implant did not affect the prevalence of concurrent SMD in patients with recurrent CME.

Optic disc coloboma associated with macular retinoschisis: A case report

BACKGROUNDTo report an unusual case of bilateral optic disc coloboma associated with macular retinoschisis in the left eye.CASE SUMMARYA 37-year-old woman presented with complaints of blurred and distorted vision in her left eye for more than 1 year. Fundus examination demonstrated choroidal atrophy around the optic disc in both eyes, with a cup-to-disc ratio of 0.9. Serous retinal detachment in the macular area of the left eye. Left eye macular blood flow imaging optical coherence tomography (Angio-OCT) showed macular retinal serous cleavage. En-face OCT showed that the canal gully-like structure formed by the defect of the optic disc nerve fiber layer between the optic disc and macula, serous detachment area was connected with the enlarged optic disc coloboma through the canal gully-like structure, and the fluid leaked from the enlarged and thinned optic disc coloboma into the retinal layer of the macular area. Patients with optic disc abnormalities and macular degeneration must be monitored appropriately. During the follow-up period, the use of optic disc stereography and 3D-OCT, en-face, and Angio-OCT imaging can clarify the correlation between macular retinoschisis and optic disc coloboma.CONCLUSIONMacular retinoschisis may be owing to the combined force of disc edge loss, enlarged optic disc coloboma, the canal gully-like structure formed by the defect of the nerve fiber layer around the optic disc, and the traction of the posterior vitreous cortex.

Choroidal Disorders in Staphyloma and Dome-Shaped Macula

Posterior staphyloma is described as an ectasia of the limited area of the eyewall mostly in highly myopic eyes. Dome-shaped macula (DSM), detected by optical coherence tomography (OCT) is a convex elevation of the eyewall mostly in the posterior staphyloma area. Both posterior staphyloma and DSM are also rarely seen in eyes without high myopia. The process that begins with the axial enlargement of the Bruch’s membrane (BM) in the equatorial region during axial elongation and breaks in BM play a role in the pathogenesis. It is thought that DSM may be a kind of compensation mechanism in eyes with high myopia and posterior staphyloma. The choroidal layer is relatively thinner in staphyloma and thicker in KŞM. Multimodal imaging is may be required for diagnosis. In OCT, it is important to evaluate the vertical and horizontal scans together and not to keep the scanning area within the lesion boundaries. Attention should be paid to the changes in the posterior eye wall curvature and choroidal thickness. The gradual decrease of choroidal thickness from the periphery to the staphyloma border is an important tip for diagnosis. The fact that the increase in choroidal thickness is limited to the convex elevation area in DSM with serous macular detachment should be considered in differential diagnosis with central serous chorioretinopathy. Studies on increasing the biomechanical power of the sclera in staphyloma are ongoing. It may be a good option to avoid overtreatment in the presence of complications, considering the benefit-risk ratio.

Management of Serous and Hemorrhagic Choroidal Detachments and Complications.

Management of Serous and Hemorrhagic Choroidal Detachments and Complications.

Subtenon triamcinolone injection to treat serous choroidal detachment after glaucoma surgery: A case series.

To report the effect of subtenon triamcinolone acetonide (TA) injection in the treatment of serous choroidal detachment (SCD) after glaucoma surgery. In this prospective case series, patients with persistent, non-resolving, or progressive SCD after glaucoma surgery were enrolled. For those with non-resolving or progressive SCD despite of using systemic corticosteroids, topical atropine and topical steroids, one milliliter of TA (40mg/mL) was injected inferotemporally into the posterior subtenon space. Sixteen consecutive patients with a mean ± SD age of 70.12 ± 11.12 years were included in this study. After injection of subtenon TA, SCD was completely resolved after 1 to 4 weeks, with deepening of the anterior chamber in all cases. All cases were followed for at least 6 months after the injection with no signs of recurrence. Subtenon injection of TA is a safe and effective modality of treatment for resolving a persistent or progressive SCD after glaucoma surgeries.

EFFECT OF RANIBIZUMAB AND AFLIBERCEPT ON RETINAL PIGMENT EPITHELIAL DETACHEMENT, SUBRETINAL AND INTRARETINAL FLUID IN AGE-RELATED MACULAR DEGENERATION.

The aim of the study was to compare the effect of three initial doses of the anti-VEGF ranibizumab and aflibercept medication on serous pigment epithelial detachment (PED), subretinal fluid (SRF) and intraretinal fluid (IRF) in the macula of treatment naive neovascular AMD (nvAMD) patients. The cohort consists of 148 patients, of which 74 patients were treated with ranibizumab (51 females and 23 males) and 74 with aflibercept (46 females and 28 males). The data was recorded prospectively from the moment of diagnosis and start of treatment for a period of 3 months. At the moment of diagnosis and 3 months later, an OCT examination (Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany) was performed. The OCT examination included a macular scan with 25 scans. Using the OCT instrument software, we measured the maximum anterior-posterior elevation of serous PED, the highest thickness of SRF and the largest diameter of the intraretinal cystic space. The statistical significance of differences between groups was evaluated using the t-test for continuous data and the Fisher exact test for categorical data. Changes in values of continuous variables over time were evaluated using the Wilcoxon paired test. Paired comparisons of binary parameters were determined by the McNemar test. Full regression of PED, SRF and IRF occurred in 3 (4.1%), 25 (39%) and 20 (51%) patients treated with ranibizumab, and in 5 (7.9%, p = 0.470), 28 (47%, p = 0.470) and 25 (57%, p = 0.827) patients treated with aflibercept, respectively. The average regression of PED, SRF and IRF was -60.4 &#956;m (median -37.5 &#956;m), -84.3 &#956;m (median -85 &#956;m) and -109.3 &#956;m (median -81 &#956;m) in patients treated with ranibizumab, and -46.3 &#956;m (median -30 &#956;m, p = 0.389), -127.7 &#956;m (median -104 &#956;m, p = 0.096) and -204.4 &#956;m (median -163 &#956;m, p = 0.005) in patients treated with aflibercept, respectively. We did not show a statistically significant difference in the regression rates of PED, SRF and IRF between the ranibizumab and aflibercept groups. (in patients with IRF after adjustment of the higher baseline IRF volumes in patients treated with aflibercept, p = 0.891). We are convinced that ranibizumab and aflibercept have the same effect on serous PED, SRF and IRF in the macula in patients with treatment naive nvAMD during the initial loading phase.