Topographical Quantification of Retinal Fluid in Type 3 MNV and Associations With Short-Term Visual Outcomes

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Age-related macular degeneration (AMD) is a leading cause of vision loss.
• Type 3 macular neovascularization (MNV) is an advanced form of AMD characterized by neovascularization originating from the outer retina.
• Accurate quantification of fluid accumulation is crucial for understanding disease progression and treatment response.

Purpose of the Study:

• To quantify intraretinal fluid (IRF), subretinal fluid (SRF), and subretinal pigment epithelium (sub-RPE) fluid volumes in treatment-naïve Type 3 MNV.
• To investigate the correlation between these fluid volumes and visual acuity (VA) outcomes at baseline and after anti-VEGF treatment.

Main Methods:

• Retrospective clinical cohort study analyzing optical coherence tomography (OCT) B-scans.
• Validated deep-learning segmentation strategy used to quantify IRF, SRF, and sub-RPE fluid volumes.
• Correlation analysis performed between baseline fluid volumes and VA outcomes post-anti-VEGF loading dose.

Main Results:

• Forty-six eyes with treatment-naïve Type 3 MNV were analyzed.
• Visual acuity improved significantly after anti-VEGF loading dose (0.51 to 0.33 LogMAR, P = .001).
• Baseline IRF volume in the inner retina and MNV distance from the fovea predicted baseline VA. Baseline inner retinal IRF also predicted follow-up VA.

Conclusions:

• Inner retinal IRF volume is a significant predictor of short-term visual outcomes in Type 3 MNV.
• The presence and volume of IRF negatively impact neuroretinal structures and visual function.
• Quantification of fluid using OCT and deep learning aids in predicting treatment response in AMD.