The association between optical density ratio of intraretinal fluid and visual acuity in neovascular age related macular degeneration after 36 months of follow up

Objective: To investigate the prognostic significance of optical density ratio (ODR) of intraretinal fluid (IRF) on best corrected visual acuity (deltaBCVA) in patients with neovascular age-related macular degeneration (nAMD) treated with anti-vascular endothelial growth factor (VEGF) agents. Methods: In this retrospective study, optical coherence tomography (OCT) scans of treatment-naïve eyes with nAMD treated with anti-VEGF injections were reviewed. ODR of retinal fluid compartments was calculated using strict and flexible methods in each OCT image. We used linear mixed models to investigate the relationship between ODR values on OCT and deltaBCVA after 36 months of follow up. Results: We included 86 eyes of 78 patients. We found negative associations between strict ODR of IRF (p = 0.02; coef. –0.05, 95% CI –0.10, –0.01), and flexible ODR of IRF (p = 0.03; coef. –0.05, 95% CI –0.10, –0.01), and deltaBCVA after 36 months. ODR of SRF and PED were not significantly associated with deltaBCVA. Conclusion: This is the largest study to investigate the relationship between ODR in nAMD patients and deltaBCVA. Eyes with higher ODR values of IRF are less likely to have a deterioration in BCVA over 36 months of follow up. ODR could be used as another OCT prognostic biomarker for BCVA in nAMD patients.