Long-term evolution of macular fibrosis in neovascular age-related macular degeneration

Purpose: To evaluate long-term tomographic findings in a series of neovascular age-related macular degeneration (nAMD) patients with macular fibrosis. Methods: Best corrected visual acuity (BCVA) and foveal 6-mm optical coherence tomography (OCT) of 30 eyes with stablished fibrosis due to nAMD were collected with a follow-up of five years. A reproducibility study was performed. Subfoveal retinal thickness (SRT), subfoveal fibrosis thickness (SFT), fibrosis extension and fibrosis area in a single frame were recorded. Results: Mean age was 79.7 years (53% females). Bilateral fibrosis was present at baseline in 16% of patients rising to 63% at the end of study period. BCVA was 32.2 ETDRS letters in study eyes at baseline, decreased the second year and was stable at 22 letters for the following three years. Unaffected eyes remained with stable vision (70 ETDRS letters) at five years. Intraclass correlation coefficients were above 0.9 for all measurements. SFT was reduced the first three years and stabilized the last two years. SRT experienced progressive decrease without a plateau. Fibrosis longitudinal extension and area remained unchanged during the five years. Conclusions: BCVA stabilizes from the third year on. Macular fibrosis experienced a limited compaction process with progressive neurosensory retinal thinning.