Fluid based visual prognostication in Type 3 macular neovascularization (MNV)- FLIP-3 Study

• Published in: Retina (Philadelphia, Pa.) Vol. 42; no. 1; pp. 107 - 113
• Main Authors: Sharma, Ashish, Gemmy Cheung, Chui Ming, Arias-Barquet, Luis, Ozdek, Sengul, Parachuri, Nikulaa, Kumar, Nilesh, Hilely, Assaf, Zur, Dinah, Loewenstein, Anat, Vella, Giovanna, Bandello, Francesco, Querques, Giuseppe
• Format: Journal Article
• Language: English
• Published: United States by Ophthalmic Communications Society, Inc 01-01-2022
• Subjects: Aged; Aged, 80 and over; Female; Fluorescein Angiography - methods; Follow-Up Studies; Fundus Oculi; Humans; Macula Lutea - diagnostic imaging; Male; Middle Aged; Prognosis; Retinal Neovascularization - diagnosis; Retinal Neovascularization - physiopathology; Retrospective Studies; Subretinal Fluid; Tomography, Optical Coherence - methods; Visual Acuity
• ISSN: 0275-004X; 1539-2864
• DOI: 10.1097/IAE.0000000000003261

To analyze the effect of fluid on visual acuity in cases of Type 3 macular neovascularization.
This multicentric, retrospective cohort study included eyes with treatment-naïve Type 3 macular neovascularization. Analysis of fluid in different compartments was performed. Group A included eyes with isolated intraretinal fluid, whereas Group B included eyes with intraretinal fluid in conjunction with subretinal fluid and/or sub retinal pigment epithelial fluid.
Eyes in Group A (31, 55.3%) had better best-corrected visual acuity of 20/50 snellen equivalent (0.42 ± 0.31 logarithm of the minimum angle of resolution) at baseline and 20/50 snellen equivalent (0.40 ± 0.28 logarithm of the minimum angle of resolution) at complete resolution compared with Group B with visual acuity of 20/80 snellen equivalent (0.64 ± 0.35 logarithm of the minimum angle of resolution) (P = 0.0181) at baseline and 20/100 snellen equivalent (0.70 ± 0.40 logarithm of the minimum angle of resolution) (P = 0.0021) at complete resolution. Subfoveal atrophy was more in Group B (82.6% 19/23) at complete resolution in comparison to Group A (16/31, 51.6%). Eyes in Group B needed more anti-vascular endothelial growth factor injections (10.3 ± 9.0) for complete resolution compared with Group A (5.7 ± 4.8).
Intraretinal fluid may be associated with good visual acuity in Type 3 macular neovascularization in contrast to other forms of neovascular age related macular degeneration. Furthermore, intraretinal fluid in isolation may need fewer injections and could probably be associated with less subfoveal atrophy.