Non-neovascular age-related macular degeneration with subretinal fluid

Assaf Hilely, Adrian Au, K. Bailey Freund, Anat Loewenstein, Eric H. Souied, Dinah Zur, Riccardo Sacconi, Enrico Borrelli, Enrico Peiretti, Claudio Iovino, Yoshimi Sugiura, Abdallah A. Ellabban, Jordi Monés, Nadia K. Waheed, Sengul Ozdek, Duygu Yalinbas, Sarah Thiele, Luísa Salles De Moura Mendonça, Mee Yon Lee, Won Ki LeePierre Turcotte, Vittorio Capuano, Meryem Filali Ansary, Usha Chakravarthy, Albrecht Lommatzsch, Frederic Gunnemann, Daniel Pauleikhoff, Michael S. Ip, Giuseppe Querques, Frank G. Holz, Richard F. Spaide, Srini Vas Sadda, David Sarraf*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose To evaluate the various patterns of subretinal fluid (SRF) in eyes with age-related macular degeneration (AMD) in the absence of macular neovascularisation (MNV) and to assess the long-term outcomes in these eyes. Methods This retrospective study included only eyes with non-neovascular AMD and associated SRF. Eyes with evidence of MNV were excluded. Spectral-domain optical coherence tomography (SD-OCT) was obtained at baseline and at follow-up, and qualitative and quantitative SD-OCT analysis of macular drusen including drusenoid pigment epithelial detachment (PED) and associated SRF was performed to determine anatomic outcomes. Results Forty-five eyes (45 patients) were included in this analysis. Mean duration of follow-up was 49.7±36.7 months. SRF exhibited three different morphologies: crest of fluid over the apex of the drusenoid PED, pocket of fluid at the angle of a large druse or in the crypt of confluent drusen or drape of low-lying fluid over confluent drusen. Twenty-seven (60%) of the 45 eyes with fluid displayed collapse of the associated druse or drusenoid PED and 24 (53%) of the 45 eyes developed evidence of complete or incomplete retinal pigment epithelial and outer retinal atrophy. Conclusion Non-neovascular AMD with SRF is an important clinical entity to recognise to avoid unnecessary anti-vascular endothelial growth factor therapy. Clinicians should be aware that SRF can be associated with drusen or drusenoid PED in the absence of MNV and may be the result of retinal pigment epithelial (RPE) decompensation and RPE pump failure.

Original languageEnglish
Pages (from-to)1415-1420
Number of pages6
JournalBritish Journal of Ophthalmology
Issue number10
StatePublished - 1 Oct 2021
Externally publishedYes


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