Effect of residual fluid on visual function in ranibizumab-treated naovascular age-related macular degeneration

The authors are commenting on the study entitled: “Effect of residual fluid on visual function in ranibizumab-treated neovascular age-related macular degeneration” published by Holekamp et al. in American Journal Ophthalmology 2021 (doi.org/10.1016/j.ajo,2021.o6.029; Published on July 17, 2021), which assessed the relationship between retinal fluid and vision in 917 pactients aged ≥ 50 years with subfoveal neovascular age-related macular degeneration associated with subretinal and/or intraretinal fluid. Patients were treated with intravitreal ranivizumab 0.5 or 2.0 mg and best-corrected visual acuity and its change were evaluated from baseline at months 12/24. Eyes with residual subretinal fluid only exhibited the largest mean best-correected visual acuity gains followed by those with resolved subretinal/intraretinal fluid (dry retina), residual subretinal/intraretinal fluid, aud residual intraretinal fluid only. The authros concluded that vision outcomes through months 24 were better in ranibizumab-treated eyes with residual versus resolved subretinal fluid and worse with residual versus resolved intraretinal fluid.We believe that the validation, extrapolation, and generalizability of these findings can be made only by regression analyses including all the missing data referred to above by us in addition to the baseline characteristics already assessed in this study, serving to identify the potential prognosticators influencing the effect of residual retinal fluid on visual function in ranibizumab-treated neovascular age-related macular degeneration over 2 years of follow-up after the initiation of treatment.