To investigate the functional outcome of eyes with neovascular age-related macular degeneration (nAMD) treated with ranibizumab which retain good visual acuity despite chronic, persistent subretinal fluid (SRF).


This retrospective, interventional case series included 12 eyes of 11 patients with nAMD which have (mean age, 70.2 years; range, 58 to 78 years) persistent SRF despite anti-VEGF therapy, and good long-term visual acuity of 20/25 or greater were reviewed. Each subject was treated with intravitreal injections of 0.5 mg ranibizumab in regular protocols. The primary outcomes included change in best-corrected visual acuity, central foveal thickness (CST), and central subretinal fluid thickness on spectral domain optical coherence tomography (SD-OCT).


The mean follow-up time was 16.6±12 months (range, 10 to 38 months). The mean number of injections was 3.2 (range 3-4). At the final visit, mean visual acuity and central foveal thickness improved significantly from 20/30 (logarithm of minimum angle of resolution (logMAR) 0.22 ± 0.07; 0.3-0.1) and 387 ± 71 μm (range, 293-465 μm) at baseline to 20/22 (logarithm of minimum angle of resolution 0.05 ± 0.05; 0.1-0.0) (P = 0.042) and 323 ± 34 μm (range, 269-358 μm) (P = 0.043), respectively. Average final subretinal fluid thickness was 106.4 μm. On a follow-up for more than 6 months, visual acuities remained stable at 20/25 or better in all eyes.


Neovascular AMD with subfoveal fluid refractory to retreatment with ranibizumab may still allow good and maintained visual improvement. Protective effect on photoreceptor integrity of persistent SRF in patients with nAMD should be taken into account.

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