Subretinal fluid protective of vision, CATT study finds

 

Take home

Subretinal fluid was associated with better visual acuity, whereas greater thickness of the subretinal tissue complex was associated with worse visual acuity in the second year of the Comparison of Age-related Macular Degeneration Treatment Trials.

 

 

By Michelle Dalton, ELS; Reviewed by Sumit Sharma, MD

Durham, NC-Eyes with foveal intraretinal fluid, abnormally thin retinas, and those developing a geographic atrophy or scar had the worst visual acuity in an assessment of morphologic features associated with visual acuity in the second year of the Comparison of Age-related Macular Degeneration (AMD) Treatment Trials (CATT).

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The purpose of the study was to look at “which factors on optical coherence tomography (OCT) are predictive of visual acuity changes,” said Sumit Sharma, MD, clinical associate, Department of Ophthalmology, Duke Eye Center, Durham, NC.

“That's the main goal,” Dr. Sharma said. “We expected certain things-that having fluid gives patients worse vision, [or] that having a scar or geographic atrophy gives patients worse vision.”

What the group did not expect to find, however, was that subretinal fluid under the fovea was actually protective of vision.

Several theories exist about the potential reasons why subretinal fluid in that location seems to be protective, “but some think it may be because we’re drying out those patients too much and it’s leaving them more atrophied,” Dr. Sharma said. “Even when we controlled and accounted for that with multivariate regression models, we still found subretinal fluid is protective.”

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