Clinical Manifestation of Retinal Pigment Epithelial Tear after Treatment of Age-Related Macular Degeneration.

Kim, Moses; Chae, Ju Byung

doi:2013.54.10.1540

J Korean Ophthalmol Soc > Volume 54(10); 2013 > Article

Original Article

Journal of the Korean Ophthalmological Society 2013;54(10):1540-1545.
DOI: https://doi.org/10.3341/jkos.2013.54.10.1540 Published online October 15, 2013.

Clinical Manifestation of Retinal Pigment Epithelial Tear after Treatment of Age-Related Macular Degeneration.

Moses Kim, Ju Byung Chae

Department of Ophthalmology, Chungbuk National University School of Medicine, Cheongju, Korea. jbchae@chungbuk.ac.kr

삼출성 노인황반변성에 대한 치료 후 발생한 망막색소상피파열의 임상결과

김모세⋅채주병

Department of Ophthalmology, Chungbuk National University School of Medicine, Cheongju, Korea

Abstract

PURPOSE
To determine the risk factors of retinal pigment epithelial (RPE) tears developed after treatment of exudative age-related macular degeneration (AMD) and to report its clinical manifestations. 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 the time from first injection to development of the RPE tear and pre- and post-RPE tear visual acuity. The visual acuity conservational interval was defined between the time the RPE tear occurred and the time visual acuity decreased 5 letters or more from pre-RPE tear visual acuity. RESULTS: A total of 219 eyes were treated with intravitreal bevacizumab, ranibizumab or PDT. Ten eyes from 10 patients developed a RPE tear (4.6%); 7 were occult choroidal neovasculization (CNV) and 3 were polypoidal choroidal vasculopathy (PCV). The average age of the RPE tear patients was 75.4 years which is statistically greater than the others (65.7) (p = 0.001). Ninety percent (9/10) of the RPE tears occurred within the first 12 weeks after treatment started. Five patients conserved their visual acuity for approximately 4 months after the RPE tear occurred. However, all 10 patients had poor visual acuity within 1 year of the follow-up period. CONCLUSIONS: RPE tears occur after intravitreal anti-VEGF antibody or PDT treatments for exudative AMD in elderly patients. Visual acuity could be conserved in the early period after a RPE tear occurred but decreased within the next year.

Key Words: Bevacizumab;Photodynamic therapy;Ranibizumab;Retinal pigment epithelium tear