J Korean Ophthalmol Soc.  2013 Oct;54(10):1540-1545.

Clinical Manifestation of Retinal Pigment Epithelial Tear after Treatment of Age-Related Macular Degeneration

• Kim M
• Chae JB

Abstract

PURPOSE
To determine the risk factors of retinal pigment epithelial (RPE) tears developed after treatment of exudative age-related macular degeneration (AMD) and to report its clinical manifestations.
METHODS
A retrospective, consecutive chart review was performed for all patients with exudative AMD treated with intravitreal anti-vascular endothelial growth factor (VEGF) antibody or photodynamic therapy (PDT) between March 2010 and January 2013. The main outcome measures were the time from first injection to development of the RPE tear and pre- and post-RPE tear visual acuity. The visual acuity conservational interval was defined between the time the RPE tear occurred and the time visual acuity decreased 5 letters or more from pre-RPE tear visual acuity.
RESULTS
A total of 219 eyes were treated with intravitreal bevacizumab, ranibizumab or PDT. Ten eyes from 10 patients developed a RPE tear (4.6%); 7 were occult choroidal neovasculization (CNV) and 3 were polypoidal choroidal vasculopathy (PCV). The average age of the RPE tear patients was 75.4 years which is statistically greater than the others (65.7) (p = 0.001). Ninety percent (9/10) of the RPE tears occurred within the first 12 weeks after treatment started. Five patients conserved their visual acuity for approximately 4 months after the RPE tear occurred. However, all 10 patients had poor visual acuity within 1 year of the follow-up period.
CONCLUSIONS
RPE tears occur after intravitreal anti-VEGF antibody or PDT treatments for exudative AMD in elderly patients. Visual acuity could be conserved in the early period after a RPE tear occurred but decreased within the next year.

Keyword

Bevacizumab; Photodynamic therapy; Ranibizumab; Retinal pigment epithelium tear

MeSH Terms

Aged
Antibodies, Monoclonal, Humanized
Choroid
Endothelial Growth Factors
Eye
Follow-Up Studies
Humans
Macular Degeneration*
Outcome Assessment (Health Care)
Photochemotherapy
Retinaldehyde*
Retrospective Studies
Risk Factors
Triazenes
Visual Acuity
Bevacizumab
Ranibizumab
Antibodies, Monoclonal, Humanized
Endothelial Growth Factors
Retinaldehyde
Triazenes

Figure

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  Figure 1. This figure shows fundus photo & fluorescein angiography (FA) of patient 9. (A, B) There is a subfoveal choroidal neovascular membrane (arrows) before development of retinal pigment epithelial (RPE) tear. (C, D) RPE tear was developed and rolled RPE is shown (arrows).

Reference

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