Discipline of Ophthalmology, Save Sight Institute, the University of Sydney, Sydney Medical School, Sydney, Australia.
Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.
Retina. 2021 Jul 1;41(7):1446-1454. doi: 10.1097/IAE.0000000000003061.
Assess the relationship between subretinal fluid (SRFL), intraretinal fluid, and visual outcomes of neovascular age-related degeneration in routine clinical practice.
Treatment-naive eyes enrolled in the Fight Retinal Blindness! registry after January 2017 were identified. Lesion activity was graded at each visit as inactive, active not SRFL only (A-NSRFL only), or active SRFL only (A-SRFL only). Eyes were grouped based on initial activity as follows: 1) initially A-NSRFL only or 2) initially A-SRFL only, and their predominant activity status over 12 months was as follows: 1) mostly inactive, 2) mostly A-NSRFL only, or 3) mostly A-SRFL only.
Seven hundred and three eyes were eligible for analysis. Initially A-NSRFL only had a similar adjusted mean 12-month visual acuity change to initially A-SRFL eyes (5.7 vs. 6.9 letters; P = 0.165), but their final visual acuity was worse (62.5 vs. 67.5 letters at 12 months; P = 0.003). The adjusted mean 12-month visual acuity change between the predominant activity groups was significantly different (P = 0.005), with mostly inactive (7.6 letters) and mostly A-SRFL only (7.5 letters) eyes gaining more than mostly A-NSRFL only eyes (3.6 letters).
Eyes with SRFL only had similar outcomes at 1 year to eyes that were mostly inactive. Intraretinal fluid was associated with worse visual outcomes, highlighting the importance of distinguishing between intraretinal fluid and SRFL when managing neovascular age-related degeneration.
在常规临床实践中评估脉络膜新生血管性年龄相关性黄斑变性的视网膜下液(SRFL)、视网膜内液与视力结局之间的关系。
于 2017 年 1 月后纳入 Fight Retinal Blindness! 注册研究中未经治疗的眼。每次就诊时,根据病变活动性将病变分级为不活动、非仅 SRFL 活动(A-NSRFL 仅)或仅 SRFL 活动(A-SRFL 仅)。根据初始活动性将眼分为以下两组:1)初始时为 A-NSRFL 仅或 2)初始时为 A-SRFL 仅,且其在 12 个月内的主要活动状态为:1)多数不活动,2)多数为 A-NSRFL 仅,或 3)多数为 A-SRFL 仅。
703 只眼符合分析条件。初始时为 A-NSRFL 仅的眼与初始时为 A-SRFL 仅的眼 12 个月时的平均调整视力变化相似(5.7 与 6.9 个字母;P=0.165),但最终视力较差(12 个月时为 62.5 与 67.5 个字母;P=0.003)。主要活动组间的平均调整 12 个月视力变化差异有统计学意义(P=0.005),多数不活动(7.6 个字母)和多数 A-SRFL 仅(7.5 个字母)眼比多数 A-NSRFL 仅眼(3.6 个字母)获得更多视力改善。
仅存在 SRFL 的眼在 1 年时的结局与多数不活动的眼相似。视网膜内液与较差的视力结局相关,这突出表明在管理新生血管性年龄相关性黄斑变性时区分视网膜内液和 SRFL 的重要性。