gms | German Medical Science

Purpose: In part of age-related macular degeneration the pigment epithelium is serously elevated resulting in a usually rather bad prognosis concerning visual acuity. As securely established therapy in wet age-related macular degeneration intravitreal injections of Anti-VEGF have shown to be an effective treatment. But their effectiveness in reducing the PED is yet to be shown.

Methods: In summary 37 patients with PED have been treated with intravitreal injections of either Ranibizumab (25 patients) or Bevacizumab (12 patients). In a retrospective analysis the following development in visual acuity and central retinal thickness including thickness of the PED was examined by optical coherence tomography one month, four months and six months after injection.

Results: In the Ranibizumab arm of treatment pre-injection visual acuity reached from 0,05 up to 0,6. One month after treatment visual acuity in the average rose up by 0,165, after four months by 0,172 and after six months by 0,153. The OCT in the beginning showed an average central retinal thickness above the PED of 321 µm, the PED covering an average of 302 µm. Central retinal thickness reduced to 258 µm after six months, probably due to reduce of fluid storage in the retinal layer above the PED. PED itself remained stable throughout the observation period with 313 µm after six months. Similar results were observed in the Bevacizumab arm of treatment: With pre-injection visus reaching from 0,05 to 0,6 the visual acuity after six months showed an increasement by 0,16 in the average. The thickness of the PED, starting with averagely 288 µm, showed an increasement up to 314 µm after six months of observation.

Conclusions: Increasement in visual acuity after injection of Anti-VEGF seems not to be caused by decreasement of PED but by reduce of intraretinal fluid storage in the retina layer above the PED. In this observation series no difference between treatment with Ranibizumab and Bevacizumab was found.