J Korean Ophthalmol Soc.  2020 Jul;61(7):755-764. 10.3341/jkos.2020.61.7.755.

Predictors of Retinal Pigment Epithelial Tears in Exudative Macular Degeneration with High Pigment Epithelial Detachment

• Yang HJ
• Kim KS

• KMID: 2504315
• DOI: http://doi.org/10.3341/jkos.2020.61.7.755

Abstract

Purpose
To evaluate the risk factors for retinal pigment epithelium (RPE) tear after intravitreal anti-vascular endothelial growth factor treatment in patients with exudative age-related macular degeneration, associated with high pigment epithelial detachment (PED) (>400 μm).
Methods
Fifty-five treatment-naive patients with high PED (>400 μm) and exudative age-related macular degeneration, treated with an initial series of 3 monthly loading injections between January 2013 and December 2017, were retrospectively included.
Results
The RPE tear rate was 16.4% (9/55). The areas affected by choroidal neovascularization and PED were significantly larger in the tear group compared with the no-tear group (p = 0.004, p = 0.029, respectively). The rate of intraretinal fluid (IRF) was 89% and 28% in the tear and no-tear groups, respectively (p = 0.001), and the subfoveal choroidal thickness was significantly thinner in the tear group (p = 0.003). There was no significant difference with respect to age, sex, laterality, underlying disease, baseline visual acuity, diagnosis, type of PED, or presence of subretinal fluid between the tear and no-tear groups. According to logistic regression analysis findings, the presence of IRF is associated with a higher risk of RPE tear (odds ratio = 20.3, p = 0.007).
Conclusions
The presence of IRF was associated with RPE tear development after intravitreal injection for exudative age-related macular degeneration.

Keyword

Retinal pigment epithelial detachment; Retinal pigment epithelium tear