Kerri Fitzgerald

DocwireNews

Total retinal fluid index (TRFI) is a novel optical coherence tomography (OCT) parameter in wet age-related macular degeneration (AMD) that estimates the proportion of fluid volume against total retinal volume in a designated area, represented as a fluid percentage.&nbsp;A study found that TRFI analysis provides a unique estimate of fluid burden following anti-vascular endothelial growth factor therapy in wet AMD.&nbsp;The results of the study were published as part of the American Society of Retina Specialists 2020 Virtual Annual Meeting.The randomized, double-masked, prospective, phase II, 56-week OSPREY trial compared brolucizumab 6 mg (every eight weeks followed by every 12 weeks) versus aflibercept 2 mg (every eight weeks) in 90 treatment-na&iuml;ve patients with wet AMD. Macular OCT scans underwent multi-layer segmentation with fluid object extraction using a novel analysis platform.TRFI was defined as 100 &times; (intraretinal + subretinal fluid volume) / total retina + fluid compartment volume; total retina + fluid compartment volume was the space between the internal limiting membrane and retinal pigment epithelium. Zone of TRFI assessment included total macular (entire macular cube), central macular (central 2 mm), and central subfield (central 1 mm).The study observed a rapid decrease in the TRFI in all zones (total macular, central macular, and central subfield) from baseline in both the brolucizumab and aflibercept groups (P&lt;0.005 for all time points).Total macular TRFI at baseline was 3.8% in the brolucizumab cohort and 3.4% in the aflibercept group.&nbsp;At week 40, total macular TRFI decreased to 0.2% and 0.3%, respectively, with similar values observed at week 56. Central macular TRFI at baseline was 8.7% in the brolucizumab cohort and 7.4% in the aflibercept group. At weeks four, 40, and 56, these values were 0.9%, 0.7%, and 0.7%, respectively, in the brolucizumab group and 2.6%, 0.9%, and 2.0%, respectively, in the aflibercept group.Central subfield TRFI at baseline was 13.9% and 11.2% in the brolucizumab and aflibercept groups, respectively. The central subfield TRFI following brolucizumab versus aflibercept treatment was 1.6% versus 4.0% (P=0.04), 1.3% versus 1.6% (P=0.74), and 1.0% versus 3.1% (P=0.08) at weeks four, 40, and 56, respectively.&ldquo;This novel OCT parameter needs further exploration as a biomarker for response and outcomes.&nbsp;The results in this analysis are consistent with previous OSPREY analyses demonstrating a reduction in fluid burden with brolucizumab every eight weeks, which is maintained with every 12 week dosing,&rdquo; the researchers concluded.Srivastava S, Clark J, Uchida A, et al. Longitudinal Total Retinal Fluid Index Assessment in nAMD From the OSPREY Study: A Novel Assessment of Fluid Drying Effect. Presented during the ASRS 2020 Virtual Annual Meeting, July 24-26, 2020.

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Use of Total Retinal Fluid Index to Estimate Fluid Volume in Wet AMD

ASRS 2020

Total retinal fluid index (TRFI) is a novel optical coherence tomography (OCT) parameter in wet age-related macular degeneration (AMD) that estimates the proportion of fluid ...

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