The impact of fluid on visual acuity in exudative macular neovascularization type 1: A long-term real-life AMD study

Purpose To evaluate the dynamics of retinal fluid in eyes compromised by exudative macular neovascularization beneath the retinal pigment epithelium (MNV type 1) secondary to neovascular age-related macular degeneration (nAMD) and its impact on disease control over time. Methods In this retrospective single center study, 65 eyes of 65 patients with treatment-naive exudative MNV Type 1 were analyzed for the presence of subretinal fluid (SRF) and intraretinal fluid (IRF) in structural OCT B-scans for three years. All eyes started on three monthly intravitreal anti-VEGF injections followed by a personalized treatment interval. Primary outcome measure was visual acuity score (VAS) change based on fluid dynamics. Results 29 (45%) eyes with SRF only started with a VAS of 74 ± 9 letters ETDRS, 20 eyes (31%) with SRF in the beginning that developed additional IRF had an initial VAS of 68 ± 11 letters, and 16 eyes (25%) with both, SRF and IRF measured 63 ± 13 letters at presentation. The VAS of all patients declined significantly ( p = 0.003) over time, but no significant VAS change was measured between the groups. Conclusion IRF was regarded as a negative predictive OCT biomarker towards a lower VAS at the beginning but not necessarily during the course of the disease.