gms | German Medical Science

Background: The treatment of exudative age-related macular degeneration (AMD) with anti-vascular endothelial growth factor (VEGF) inhibitors has more and more been accepted within the last months due to multi-center, randomized trials. Further on, the time period for the intravitreal treatment in each individual case and the specific interval for injections are not yet clarified. A special form of exudative AMD is the associated serous retinal pigment epithelium detachment (PED). The main reason for a continuing decrease of the visual acuity is a frequent recurrence of the choroidal neovascularization (CNV) as well as tears of retinal pigmentepithelium (RIP).

Method: The report refers to 126 eyes in 125 patients with serous PED; it is reported retrospectively and consecutively. The patient’s mean age was 77.8 years. The best corrected visual acuity (BCVA) was collected in LogMAR. In addition, the optical coherence tomography (OCT) was performed and, therefore, morphological parameters such as fovea full thickness and the manual measurement of the height of PED as well as the FAG/ICG angiograph analysed. The anti-VEGF therapy was repeated 3 times in a 4-week-interval. The basis for the analysis is a median follow-up time of 18 weeks.

Results: The treatment of all patients was tolerated without complications in the time of observation. In the first half of the observation period increased visual acuity and came second section to a significant deterioration. All changes of visual acuity in the course were significant (p = 0.001). The central retinal thickness measured by OCT decreased significantly (p = 0.001). A functional and morphological differences in the results was not between vascularized PED and retinal angiomatous proliferation (RAP) with PED recognizable. The occurrence of RIP was observed in 17 eyes (13.5%). Patient with an RIP showed a significantly greater loss of vision (p = 0.0002).

Conclusion: The anti-VEGF therapy is effective in the serous PED in the context of exudative AMD. Visual acuity and morphology can be influenced only within the first six months slightly positive. The occurrence of a RIP continue to rest with all therapeutic options, and for all VEGF inhibitors equally a problem. The functional deterioration after a half in a treatment regimen based on the PRONTO - scheme to renewed discussions about treatment strategies and possible prognostic factors must give rise.