J Korean Ophthalmol Soc > Volume 54(10); 2013 > Article
Journal of the Korean Ophthalmological Society 2013;54(10):1546-1553.
DOI: https://doi.org/10.3341/jkos.2013.54.10.1546    Published online October 15, 2013.
Risk Factors for Retinal Pigment Epithelium Tears after Anti-VEGF Agent Injection in Age-Related Macular Degeneration.
Woo Seok Choae, Jae Hong Park, Woo Seok Lee, Sang Won Kim, Hee Seong Yoon
Sungmo Eye Hospital, Busan, Korea. heesyoon@dreamwiz.com
연령관련황반변성에서 유리체강내 혈관내피성장인자억제제 주입술 후 망막색소상피파열의 위험인자
최우석⋅박재홍⋅이우석⋅김상원⋅윤희성
Sungmo Eye Hospital, Busan, Korea
Abstract
PURPOSE
Intravitreal anti-vascular endothelial growth factor (VEGF) treatment has become an important part in the treatment of neovascular age-related macular degeneration (AMD). In the present study we describe the clinical feature of retinal pigment epithelium (RPE) tears after intravitreal injection of anti-VEGF agent and compared the tear group to the control group. METHODS: In this retrospective case series, data of 11 patients with eyes that developed RPE tears after intravitreal anti-VEGF injection (8 ranibizumab and 3 bevacizumab) were collected and analyzed. The tear group included 11 patients with eyes that developed RPE tears and the control group included 22 patients with no RPE tears after treatment. We investigated age, gender, bilaterality, duration from injection to tear, pigment epithelial detachment (PED) height and diameter, along with central retinal thickness (CMT) using optical coherence tomography (OCT), fluorescein angiography (FAG), and visual acuities before and after treatment. RESULTS: The mean age of the tear group was 81.36 +/- 5.55 years which was significantly different from the control group's mean age of 74.82 +/- 5.28 years (p = 0.003). OCT findings showed PED greatest linear dimension (GLD) was 2978.45 +/- 947.69 microm in the tear group and 2250.23 +/- 988.49 microm in the control group (p = 0.027). PED height was 507.09 +/- 153.97 microm in the tear group and 353.23 +/- 199.42 microm in the control group (p = 0.010). CMT was 431.64 +/- 200.33 microm in the tear group and 289.95 +/- 61.27 microm in the control group (p = 0.005). There was no significant difference between groups according to gender, bilaterality, visual acuities, and subretinal fluid based on OCT and FAG findings. In the tear group, visual acuities before and after the tear were not significantly different. CONCLUSIONS: Old age and eyes with high and wide PED appear to be more vulnerable to RPE tear. Further investigation with a larger number of patients is needed to further confirm these results.
Key Words: Bevacizumab;Intravitreal injection;PED;Ranibizumab;RPE tear


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