CLINICAL COURSE AND PROGNOSTIC FACTORS IN NONNEOVASCULAR AGE-RELATED MACULAR DEGENERATION WITH SUBRETINAL FLUID

Area of Science:

• Ophthalmology
• Retinal Diseases
• Macular Degeneration

Background:

• Age-related macular degeneration (AMD) is a leading cause of vision loss.
• Pigment epithelial detachment (PED) and subretinal fluid (SRF) are common findings in AMD.
• The progression of AMD without macular neovascularization (MNV) in the presence of PED and SRF requires further investigation.

Purpose of the Study:

• To examine the clinical course of AMD in patients with PED and SRF but without MNV.
• To identify prognostic factors associated with the progression to late AMD, including complete retinal pigment epithelium and outer retinal atrophy (cRORA) or MNV.

Main Methods:

• Spectral-domain optical coherence tomography (SD-OCT) imaging was used to analyze morphological characteristics.
• Anatomic outcomes were assessed.
• Factors predicting progression to cRORA or MNV were investigated using multivariate analysis.

Main Results:

• Fifty eyes from 41 patients were analyzed.
• SRF was most commonly located at the PED angle (56%).
• Over a mean follow-up of 52.1 months, 22% of eyes developed cRORA and 14% developed MNV.
• Hyperreflective foci, fellow eye MNV, and higher PED height were associated with progression.

Conclusions:

• Subretinal fluid can occur with pigment epithelial detachment in AMD even without macular neovascularization.
• This clinical presentation can progress to advanced forms of AMD, such as cRORA and MNV, in a significant number of patients.