gms | German Medical Science

23rd Annual Meeting of the German Retina Society

German Retina Society

24.09. - 25.09.2010, Freiburg

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Pigment epithelium tears following intravitreal anti-VEGF-therapy for vascularised pigment epithelium detachment (PED) in AMD: development of morphology and visual acuity

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  • Matthias Gutfleisch - Department of Ophthalmology St. Franziskus Hospital Münster
  • B. Heimes - Department of Ophthalmology St. Franziskus Hospital Münster
  • M. Schuhmacher - Department of Ophthalmology St. Franziskus Hospital Münster
  • G. Spital - Department of Ophthalmology St. Franziskus Hospital Münster
  • A. Lommatzsch - Department of Ophthalmology St. Franziskus Hospital Münster
  • D. Pauleikhoff - Department of Ophthalmology St. Franziskus Hospital Münster

German Retina Society. 23rd Annual Conference of the German Retina Society. Freiburg i. Br., 24.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10rg11

doi: 10.3205/10rg11, urn:nbn:de:0183-10rg116

This is the English version of the article.
The German version can be found at: http://www.egms.de/de/meetings/rg2010/10rg11.shtml

Published: September 21, 2010

© 2010 Gutfleisch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Background: Pigment epithelium (RPE) tears are a typical complication after intravitreal anti-VEGF treatment for vascularised PEDs in exsudative AMD. This study analyses morphological aspects and best corrected visual acuity (BCVA) of RPE-tears over 12 months.

Methods: Monocenter, retrospective study of patients (n=37) with RPE-tears following bevacizumab (n=11), ranibizumab (n=22) and pegaptanib (n=4) treatment. We analysed different morphologic aspects and BCVA by means of appearance in fluorescein angiography and optical coherence tomography over 12 months.

Results: BCVA worsened directly after a RPE-tear and deteriorated significantly during the follow-up (p<0,001). Eyes with a RIP area > 10 mm2 in diameter showed worse development of BCVA (p=0,012). Onset of RPE-tear showed no significant correlation to development of BCVA (p=0,72). Change of retinal vessel course was seen more often in PEDs associated with occult CNV than those associated with RAP-lesions (p=0,015). Course of BCVA was worse in those eyes (p=0,004).

Conclusion: Development of RPE tears after Anti-VEGF-Therapy is associated with deterioration of BCVA due to development of a dicsciform scar or foveal involvement of the RPE tear. Change of vessel course and RPE-free area seem to be associated with worse course of VA. Possible development of RPE tear should be considered if intravitreal anti-VEGF treatment is discussed.