PT - JOURNAL ARTICLE AU - Marco A Zarbin AU - Lauren Hill AU - Andreas Maunz AU - Martin Gliem AU - Ivaylo Stoilov TI - Anti-VEGF-resistant subretinal fluid is associated with better vision and reduced risk of macular atrophy AID - 10.1136/bjophthalmol-2020-318688 DP - 2021 May 26 TA - British Journal of Ophthalmology PG - bjophthalmol-2020-318688 4099 - http://bjo.bmj.com/content/early/2021/05/26/bjophthalmol-2020-318688.short 4100 - http://bjo.bmj.com/content/early/2021/05/26/bjophthalmol-2020-318688.full AB - Background/aim To evaluate relationships between subretinal fluid (SRF), macular atrophy (MA) and visual outcomes in ranibizumab-treated neovascular age-related macular degeneration (nAMD).Methods This post hoc HARBOR trial (NCT00891735) analysis included ranibizumab-treated (0.5 or 2.0 mg, monthly or as-needed, all treatment arms pooled) eyes with nAMD and baseline (screening, baseline and week 1) SRF. SRF presence, SRF thickness (0, >0–50, >50–100 and >100 µm) and subretinal fluid volume (SRFV) were determined by spectral domain optical coherence tomography (SD-OCT). Best-corrected visual acuity (BCVA) was assessed. MA was identified using fluorescein angiograms and colour fundus photographs, as well as SD-OCT.Results Seven hundred eighty-five of 1097 eyes met analysis criteria. In eyes without baseline MA, residual versus no SRF at month (M) 3 was associated with lower MA rates at M12 (5.1% vs 22.1%) and M24 (13.3% vs 31.2%) (both p<0.0001); MA percentages at M12/M24 were similar among patients with residual SRF at M6. Higher baseline SRFV was associated with a lower MA rate. Greater mean BCVA was observed with residual SRF of any thickness (>0–50 µm, 71.2 letters; >50–100 µm, 71.3 letters; >100 µm, 69.2 letters) versus no SRF (63.6 letters), but the change in BCVA from baseline to M12 or M24 was the same for eyes with or without treatment-resistant subretinal fluid (TR-SRF) at M3 or M6.Conclusion TR-SRF was not detrimental to vision outcomes over 2 years, regardless of thickness. MA rates were significantly higher without TR-SRF.Data may be obtained from a third party and are not publicly available. Qualified researchers may request access to individual patient-level data through the clinical study data request platform (https://vivli.org/). Further details on Roche's criteria for eligible studies are available online (https://vivli.org/members/ourmembers/). Further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents are available online (https://www.roche.com/research_and_development/who_we_are_how_we_work/clinical_trials/our_commitment_to_data_sharing.htm).