gms | German Medical Science

Purpose: To assess the effects of monthly intravitreal ranibizumab injections in patients with vascularized pigment epithelial detachment (vPED) secondary to age-related macular degeneration (AMD).

Methods: A total of 40 patients were prospectively analyzed and treated monthly with 0.5mg ranibizumab injections (ClinicalTrials.gov Ident. NCT00976222). Best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) were evaluated at all visits. Fluorescein angiography and indocyanin green angiography were performed at baseline and quarterly. Change in BCVA, change in PED greatest linear diameter (GLD) and change in PED height from baseline to month 12 were determined.

Results: There were two types of PED including serous vascular PED in 31 patients (group A) and fibrovascular PED in 9 patients (group B). Mean BCVA showed a deterioration between baseline and 12-month follow-up visit of 0.26 logMAR in group A and an improvement of 0.14 logMAR in group B. The mean decrease in PED height was 645.8μm in group A and 193.2µm in group B. Mean PED GLD increased from 2916.3 μm at baseline to 3125.8 μm at 1-year follow-up (P < 0.001). After 3.6 treatments, 10 (25%) patients from group A developed a retinal pigment epithelium (RPE) tear. No tear was documented in group B.

Conclusions: Ranibizumab is an effective treatment for vPED due to AMD regarding BCVA and morphologic characteristics of vPED lesions. Considering the relatively high rate of RPE tears vPED patients should be screened for the presence of morphologic risk factors for RPE tear development. An adapted treatment regimen in such patients presumably makes ranibizumab therapy safer.