Prevalence and clinical implications of subretinal fluid in retinal diseases: a real-world cohort study

Abstract

Background/aimsTo characterise the baseline prevalence of subretinal fluid (SRF) and its effects on anatomical and visual acuity (VA) outcomes in diabetic macular oedema (DME) and retinal vein occlusion (RVO) following anti-vascular endothelial growth factor (VEGF).MethodsThis is a retrospective cohort study of 122 DME and 54 RVO patients who were initiated on anti-VEGF therapy with real-world variable dosing. The DME and RVO cohorts were subclassified based on the presence of SRF at presentation. Snellen VA was measured and converted to logarithm of the minimum angle of resolution (LogMAR). Changes in VA and central subfield thickness (CST) were assessed up to 24 months.ResultsSRF was present in 22% and 41% in DME and RVO patients, respectively. In the DME subcohort, eyes with SRF showed an improvement of 0.166 logMAR (1.7 Snellen chart lines) at 12 months and 0.251 logMAR (2.6 Snellen chart lines) at 24 months, which were significantly greater compared with those of the non-SRF group. A significantly greater reduction in CST was noted in the SRF eyes compared with the non-SRF eyes at 3 months and 1 month in the DME and RVO subcohorts, respectively.ConclusionBaseline SRF is a good marker for a greater reduction in CST in both DME and RVO, but an improvement in VA associated with SRF may be only noted in DME.

Visual Outcomes in Malignant Hypertensive Retinopathy Cases: A Clinical and Spectral Domain Optical Coherence Tomography Study

“…Many studies on vascular diseases such as diabetic retinopathy, retinal vein occlusion, and age-related macular degeneration have shown the presence of SRF has no impact on treatment outcome or visual prognosis. Rather some have found favourable outcomes with baseline SRF [18][19][20][21]. Although photoreceptor defects can occur following the resolution of chronic SRF in conditions such as chronic central serous chorioretinopathy and long-standing RD [22,23], in malignant hypertension where SRF or IRF respond early to systemic treatment, their impact on visual prognosis is debatable.…”

Subretinal fluid in macular edema secondary to branch retinal vein occlusion

“…SRF is a common finding not only in RVO but also in neovascular age-related macular degeneration, DME, and central serous chorioretinopathy 20 . VEGF mediates dysfunction of the RPE and outer retinal barrier and subsequent fluid leakage into the subretinal space 21,22 . Considering the good responsiveness of SRF to anti-VEGF, VEGF appears to play a crucial role.…”