The Impact of Residual Retinal Fluid Following Intravitreal Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Macular Edema and Macular Edema Secondary to Retinal Vein Occlusion: A Systematic Review

Abstract

The association between residual retinal fluid and visual acuity for diabetic macular edema (DME) and macular edema (ME) secondary to retinal vein occlusion (RVO) is not well established. We conducted a systematic literature search for peer-reviewed articles reporting on visual acuity stratified by subretinal fluid (SRF), intraretinal fluid (IRF), or any retinal fluid at final follow-up after intravitreal anti-vascular endothelial growth factor therapy injection for treatment of DME or ME secondary to RVO. Two observational studies on ME secondary to RVO and one study for DME found no significant differences between eyes with and without residual retinal fluid for final BCVA. One randomized controlled trial (RCT) found that eyes with residual retinal fluid had significantly worse final best-corrected visual acuity in ME secondary to RVO, whereas another RCT found no significant difference for DME. There is a paucity of evidence examining the impact of residual retinal fluid on visual acuity in DME and ME secondary to RVO. The limited evidence suggests that aggressive fluid resolution is worthwhile. [ Ophthalmic Surg Lasers Imaging Retina 2023;54:50–58.]

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“…Typical fundus changes in RVO patients include retinal hemorrhage, tortuous retinal vein dilatation, extensive retinal capillary non-perfusion area, and macular edema (Irgat and Ozcura , 2023). Late patients may have complications such as vitreous hemorrhage, traction retinal detachment, and neovascular glaucoma, resulting in severe visual acuity loss and even blindness (Altintas and Ilhan, 2023;Patil et al, 2023). Some commonly used treatment methods in ophthalmology are mainly used to prevent and treat complications such as laser photocoagulation, vitrectomy, vitreous injection of hormones, or anti-VEGF drugs (Ghanchi et al, 2022;Yin et al, 2022).…”

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“…In the early stage, the symptoms are characterized by a sudden loss of vision to varying degrees; mild patients may have no symptoms or only a little shadow (Pur et al, 2023), and with the progression of the disease, RVO patients have serious visual impairment (Zhang X. T et al, 2022;Sood et al, 2022). Typical fundus changes in RVO patients include retinal hemorrhage, tortuous retinal vein dilatation, extensive retinal capillary non-perfusion area, and macular edema (Irgat and (Altintas and Ilhan, 2023;Patil et al, 2023). Some commonly used treatment methods in ophthalmology are mainly used to prevent and treat complications such as laser photocoagulation, vitrectomy, vitreous injection of hormones, or anti-VEGF drugs (Ghanchi et al, 2022;Yin et al, 2022).…”

“…Typical fundus changes in RVO patients include retinal hemorrhage, tortuous retinal vein dilatation, extensive retinal capillary non-perfusion area, and macular edema ( Irgat and Ozcura, 2023 ). Late patients may have complications such as vitreous hemorrhage, traction retinal detachment, and neovascular glaucoma, resulting in severe visual acuity loss and even blindness ( Altintas and Ilhan, 2023 ; Patil et al, 2023 ). Some commonly used treatment methods in ophthalmology are mainly used to prevent and treat complications such as laser photocoagulation, vitrectomy, vitreous injection of hormones, or anti-VEGF drugs ( Ghanchi et al, 2022 ; Yin et al, 2022 ).…”