Clinical manifestation of retinal pigment epithelial tear after age-related macular degeneration treatment

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Abstract

Purpose

To determine the risk factors for and responses of treatments after the development of retinal pigment epithelial (RPE) tears after treatment of exudative age-related macular degeneration (AMD)

Methods

A retrospective, consecutive chart review was performed for all patients with exudative AMD treated with intravitreal anti-vascular endothelial growth factor (VEGF) antibody or photodynamic therapy (PDT) between March 2010 and January 2013. The main outcome measures were time from first injection until development of RPE tear, and pre-RPE and post-RPE tear visual acuity. The post-RPE tear visual acuity conservational interval was defined between the time RPE tear occurred and the time visual acuity was decreased 0.1(decimal) from pre-RPE tear visual acuity.

Results

A total of 219 eyes were treated with intravitreal bevacizumab, ranibizumab or PDT. 10 eyes from 10 patients developed a RPE tear(4.6%). 3 of 10 eyes were polypoidal choroidal vasculopathy (PCV). The average RPE tear patients’ age was 75.4 years which is statistically greater than the others’(65.7 years)(p=0.001). 90%(9/10) of the RPE tears occurred within the first 12 weeks of treatment initiation. The number of patients conserving whose post-RPE tear visual acuity was 5(50%) and their visual acuity was conserved until about 4 months. However, all 10 patients had poor visual acuity within 1 year follow-up period.

Conclusion

RPE tears can occur after treatments for exudative AMD in more elder patients. Visual acuity could be conserved at early period after RPE tear occurred. However, visual acuity finally decreased within 1 year in spite of continuous treatment.

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