Retinal pigment epithelial tear following intravitreal ranibizumab injections for neovascular age-related macular degeneration

Lee, Gary K. Y.; Lai, Timothy Y. Y.; Chan, Wai‐Man; Lam, Dennis S C

doi:10.1007/s00417-007-0536-2

Cited by 30 publications

(15 citation statements)

References 10 publications

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“…[15][16][17][18][19][20][21][22] As the acute visual consequences are only limited after a RPE tear has been initiated, a good visual prognosis was often presumed for this complication, which is in agreement with our findings. However, with longer follow-up this prognosis decreased significantly, with a mean loss in BCVA deterioration.…”

Section: Discussionsupporting

confidence: 89%

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Long-term visual outcome of pigment epithelial tears in association with anti-VEGF therapy of pigment epithelial detachment in AMD

Gutfleisch

Heimes

Schumacher

et al. 2011

Eye

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Purpose Retinal pigment epithelium (RPE) tears may develop as a complication after anti-VEGF (vascular endothelial growth factor) treatment for pigment epithelial detachments (PEDs) in exudative age-related macular degeneration (AMD). This retrospective study analyses best-corrected visual acuity (BCVA) and foveal involvement after RPE tears that are associated with anti-VEGF therapy due to PED in exudative AMD. Methods A total of 37 patients with RPE tears during anti-VEGF therapy (bevacizumab 12, ranibizumab 21 and pegaptanib 4 eyes) for progressive PED in AMD (PED with occult choroidal neovascularization 25 eyes and PED with retinal angiomatous proliferation 12 eyes) were included in this study. We analyzed BCVA and different morphologic aspects by means of appearance on fluorescein angiography and optical coherence tomography. Mean follow-up was 88 weeks. Results RPE tears were diagnosed a mean of 56 days after the first injection. BCVA deteriorated after RPE tear and during follow-up significantly (Po0.001), with 53.2% of eyes being legally blind (WHO, world health organization) at 12 months. RPE-free foveal area, foveal wrinkling of the RPE, and fibrotic scar development were significantly associated with worse visual acuity. Discussion RPE tears can be observed in 12-15% of treated eyes during anti-VEGF therapy for PED in exudative AMD. Owing to the close time relationship with the therapy, this complication must be taken into consideration. Visual prognosis is associated with a decrease in vision in the long term, often resulting in a severe visual disability. Relevant factors for a negative visual prognosis were the potential foveal involvement of the central RPE and morphologic fibrovascular transformation of the RPE tear.

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Section: Discussionsupporting

confidence: 89%

“…[15][16][17][18][19][20][21][22] However, little is known about the long-term outcome in these patients. The aim of the present study, therefore, was to evaluate the long-term visual and morphologic prognosis after RPE tears in association with anti-VEGF treatment.…”

Section: Introductionmentioning

confidence: 99%

Long-term visual outcome of pigment epithelial tears in association with anti-VEGF therapy of pigment epithelial detachment in AMD

Gutfleisch

Heimes

Schumacher

et al. 2011

Eye

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“…In the present study, patients with RPE tears who received additional anti-VEGF therapy were followed for a mean of 52 months (range, 36-72 months), much longer than reported previously. [6][7][8]10,12,14 We observed that the final visual outcomes were not as devastating as reported previously. 1,3,7,[9][10][11][12][13] Immediately after the tear develops, there is a sudden decrease in vision accompanied by intense metamorphopsia.…”

Section: Discussionsupporting

confidence: 71%

“…[1][2][3][4][5][6][7][8] Two studies have reported identical rates of RPE tears of 17% in eyes with a PED and neovascular age-related macular degeneration that had received anti-VEGF therapy. 15,16 Rapid contraction of the choroidal vascular membrane beneath a serous RPE detachment is believed to be the underlying cause.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,3 Retinal pigment epithelial tears can occur spontaneously 3 or after treatments for neovascular membranes, such as laser photocoagulation, 4 photodynamic therapy, 5 and anti-vascular endothelial growth factor (VEGF) drugs. 6,7,8 Although many retina specialists consider RPE tears to be visually devastating complications, 1,3,7,9,10,11,12,13 only a few studies have evaluated these tears over long periods. 11,12,14 In addition, the issue of administration of supplementary anti-VEGF injections in cases with active submacular membrane in the presence of an RPE tear has not been well defined.…”

mentioning

confidence: 99%

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Long-Term Results of Repeated Anti–vascular Endothelial Growth Factor Therapy in Eyes With Retinal Pigment Epithelial Tears

Moreira

Arana

Zago

2013

Retina

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Retinal Pigment Epithelium Tears Secondary to Age-Related Macular Degeneration

Caramoy

Kirchhof²,

Fauser³

2011

Arch Ophthalmol

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To describe the morphology of retinal pigment epithelium (RPE) tears secondary to age-related macular degeneration by using high-resolution, spectraldomain optical coherence tomography (SD-OCT). Methods: For simultaneous topographic and tomographic in vivo imaging, confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography were applied in combination. Retina over the RPE-denuded area was particularly examined for signs of viable photoreceptors. Results: A total of 26 patients (28 eyes) were included in the study. The mean (SD) age of patients was 78 (8) years (age range, 62-91 years). In cases with recent RPE tears, external limiting membrane, photoreceptor inner and outer segment junction, and nonatrophic outer nuclear layer could be identified in the retina on the RPEdenuded area. Intact external limiting membrane, photoreceptor inner and outer segment junction, and nonatrophic outer nuclear layer could be seen in 1 patient for up to 325 days after the RPE tear. In fibrotic older RPE tears, these structures were atrophic. Conclusions: In this study, signs for viable photoreceptors could be identified for up to 325 days after an RPE tear using spectral-domain optical coherence tomography. This finding is important to consider in future therapies aimed at rescuing photoreceptors after RPE tears.

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Retinal pigment epithelial tear following intravitreal ranibizumab injections for neovascular age-related macular degeneration

Abstract: As with other anti-vascular endothelial growth factor treatment for CNV, RPE tear might occur after intravitreal ranibizumab injection even after previous uneventful intravitreal injections.

Cited by 30 publications

References 10 publications

Long-term visual outcome of pigment epithelial tears in association with anti-VEGF therapy of pigment epithelial detachment in AMD

Long-term visual outcome of pigment epithelial tears in association with anti-VEGF therapy of pigment epithelial detachment in AMD

Long-Term Results of Repeated Anti–vascular Endothelial Growth Factor Therapy in Eyes With Retinal Pigment Epithelial Tears

Retinal Pigment Epithelium Tears Secondary to Age-Related Macular Degeneration

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