Document Detail

Predictors of anti-VEGF-associated retinal pigment epithelial tear using FA and OCT analysis.
MedLine Citation:
PMID:  18628724     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To identify fluorescein angiography and optical coherence tomography (OCT) predictors for retinal pigment epithelial (RPE) tear in eyes with pigment epithelium detachment (PED) associated with neovascular age-related macular degeneration treated with intravitreal vascular endothelial growth factor (VEGF) modulating therapy.
DESIGN: Retrospective comparative case series.
METHODS: In a single institutional center, 60 consecutive patients with PED and neovascular age-related macular degeneration treated with VEGF modulating therapy (either pegaptanib, bevacizumab, or ranibizumab) for more than a 27-month period were included in the study. Fluorescein angiography (FA) and OCT imaging was performed before and after anti-VEGF therapy. Formal statistical analysis comparing the tear group to the nontear group was performed to identify high-risk features for RPE tear.
RESULTS: RPE tear rate for eyes with vascularized PED receiving anti-VEGF therapy was 17% (10/60). There were highly statistically significant differences in the median PED size on fluorescein angiography (greatest linear diameter) (3.2 mm versus 1.8 mm, respectively; P < 0.001) and in the median maximum PED height on OCT (394 mum versus 149 mum, respectively; P = 0.001) between the tear group and nontear group. There was also a significant difference in terms of the presence of subretinal fluid on OCT between the two groups (87.5% versus 39%, respectively; P = 0.019).
CONCLUSION: Large PED basal diameter and vertical height are correlated with an increased risk of developing an RPE tear after anti-VEGF therapy. Patients with large vascularized PED by fluorescein angiography and/or OCT analysis should be alerted of the risk for vision loss due to RPE tear after anti-VEGF therapy.
Allen Chiang; Louis K Chang; Fei Yu; David Sarraf
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Retina (Philadelphia, Pa.)     Volume:  28     ISSN:  1539-2864     ISO Abbreviation:  Retina (Philadelphia, Pa.)     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2009-05-12     Completed Date:  2009-06-25     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  8309919     Medline TA:  Retina     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1265-9     Citation Subset:  IM    
Jules Stein Eye Institute, University of California-Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095, USA.
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MeSH Terms
Aged, 80 and over
Antibodies, Monoclonal / adverse effects,  therapeutic use
Antibodies, Monoclonal, Humanized
Aptamers, Nucleotide / adverse effects,  therapeutic use
Choroidal Neovascularization / drug therapy,  etiology
Fluorescein Angiography*
Macular Degeneration / complications
Predictive Value of Tests
Retinal Detachment / diagnosis*,  etiology
Retinal Perforations / chemically induced*
Retinal Pigment Epithelium* / blood supply
Retinal Vessels / pathology
Retrospective Studies
Risk Assessment / methods
Tomography, Optical Coherence*
Vascular Endothelial Growth Factor A / antagonists & inhibitors*
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Aptamers, Nucleotide; 0/Vascular Endothelial Growth Factor A; 0/pegaptanib; 0/ranibizumab; 2S9ZZM9Q9V/bevacizumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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