Baseline characteristics linked to early residual fluid after aflibercept treatment for age-related macular degeneration

In patients with treatment-naïve neovascular age-related macular degeneration (nAMD) undergoing aflibercept loading phase (LP), approximately 50% of eyes exhibit early residual fluid (ERF), according to a study that identified specific baseline characteristics associated with the presence of ERF as increased central subfield thickness (CST) and the presence of subretinal fluid (SRF) at baseline.

The study included a total of 2128 patients, with complete data available for 1999 eyes of 1862 patients. The findings revealed that after the LP, ERF was present in 50.0% of eyes, with 37.3% exhibiting subretinal fluid (eSRF) and 21.4% having intraretinal fluid (eIRF).

Eyes with increased CST showed a significant association with ERF, with an odds ratio (OR) of 1.31 per 100 microns increase (95% CI 1.22 to 1.41; P < 0.001). In addition, eyes with both IRF and SRF at baseline had an OR of 1.62 (95% CI 1.17 to 2.22; P = 0.003), while those with SRF only had an OR of 2.26 (95% CI 1.59 to 3.20; P < 0.001) relative to IRF only.

A Receiver Operating Characteristic curve was employed to establish a central subfield thickness (CST) threshold for distinguishing eyes with ERF from those without. A CST of ≥ 418 microns demonstrated 57% sensitivity and 58% specificity at visit 4.

Reference
Chandra S, Gurudas S, Pearce I, et al. Baseline characteristics of eyes with early residual fluid post loading phase of aflibercept therapy in neovascular AMD: PRECISE study report 3. Eye (Lond). 2023;doi: 10.1038/s41433-023-02886-1. Epub ahead of print. PMID: 38102473.