Retinal Pigment Epithelial Tear following Intravitreal Injection of Bevacizumab (Avastin)

Nicolò, Massimo; Ghiglione, D; Calabria, G.

doi:10.1177/112067210601600521

Cited by 45 publications

(26 citation statements)

References 5 publications

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“…Development of RPE tear has been reported after PDT and intravitreal anti-VEGF injections including bevacizumab and pegaptanib [2,4,5,7,8,10]. We are unaware of any report of RPE tear developing after intravitreal ranibizumab injection.…”

Section: Commentmentioning

confidence: 66%

See 1 more Smart Citation

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

Lee

Lai

Chan

et al. 2007

Graefes Arch Clin Exp Ophthalmol

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Section: Commentmentioning

confidence: 66%

“…Recently, cases of RPE tear following intravitreal anti-vascular endothelial growth factor (VEGF) injections including bevacizumab and pegaptanib have also been reported [2,4,7,8,10]. We report a patient who developed acute RPE tear following repeated intravitreal ranibizumab injections for occult CNV with PED due to AMD.…”

Section: Introductionmentioning

confidence: 82%

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

Lee

Lai

Chan

et al. 2007

Graefes Arch Clin Exp Ophthalmol

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“…[1][2][3][4] Although the visual prognosis might be different in cases with spontaneous tears, where the choroidal neovascular membrane shows no regression, the rupture and displacement of the RPE might be a serious complication with the risk of visual damage. As serous pigment epithelial detachments (PED) associated with choroidal neovascularization (CNV) are often seen before an RPE tear, stretching forces on the weakened RPE were considered to play a causative role.…”

Section: Introductionmentioning

confidence: 99%

Can the risk of retinal pigment epithelium tears after bevacizumab treatment be predicted? An optical coherence tomography study

Leitritz

Gelişken

Inhoffen

et al. 2008

Eye

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Background Retinal pigment epithelium (RPE) tears after bevacizumab treatment for neovascular age-related macular degeneration accompanied by a pigment epithelial detachment (PED) might be caused by stretching forces on the already weakened RPE. The purpose of this study was to evaluate whether simple measurements of optical coherence tomography (OCT) can predict the individual risk of an RPE tear in preoperative candidates. Methods A retrospective chart review study of 393 consecutive patients with neovascular agerelated macular degeneration evaluated OCT images (Stratus-OCT Zeiss, Jena, Germany). The height of the PED, the central retinal thickness, and the maximum retinal thickness were determined by two independent observers and retrospectively analysed. Results Fifteen patients with an RPE tear had a significant higher PED than the remaining study population. In contrast, no correlation was seen with the central retinal thickness. In a linear regression model, the probability of an RPE tear exponentially increased in dependence of the extent of PED. Conclusion The risk of an RPE tear can be estimated by simple measurement of the height of the PED on OCT.

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“…[29][30][31][32][33][34] Case series recently highlighted RPE tear increase after intravitreal bevacizumab treatment of neovascular AMD. [14][15][16][17][18][19][20][21][22][23][24][25][26] Chan et al 24 reported in a multicenter collective study 2.2% RPE tears in 1064 eyes. In a subgroup of 123 eyes with PED, 21 eyes (17.1%) had an RPE tear after intravitreal bevacizumab therapy.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14] In contrast, some cases of retinal pigment epithelial (RPE) tears after bevacizumab therapy have recently been reported. [15][16][17][18][19][20][21][22][23][24][25][26] Since intravitreal bevacizumab is a widely used therapy option for neovascular AMD, there is a need for further information on this topic. We analysed the occurrence of the RPE tear and the influence of related factors on this entity in a short-tem follow-up period following a single intravitreal bevacizumab administration for neovascular AMD.…”

Section: Introductionmentioning

confidence: 99%

Retinal pigment epithelial tears after single administration of intravitreal bevacizumab for neovascular age-related macular degeneration

Gelişken¹,

Ziemssen²,

Voelker³

et al. 2008

Eye

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Purpose To analyse retinal pigment epithelial (RPE) tears following single administration of intravitreal bevacizumab for neovascular agerelated macular degeneration (AMD) during early follow-up. Methods Interventional, retrospective, noncomparative case series included 397 patients (409 eyes) of the 746 consecutive patients that met the eligibility criteria. Standardized visual acuity testing, fluorescein angiography, and optical coherence tomography were performed. Data collected included status of the fellow eye, previous treatment, subtypes of choroidal neovascularization (CNV), size and composition of the lesion. Multiple linear regression modelling was used to explore the effect of baseline parameters on the RPE tears. Primary end point was occurrence of RPE tears within 6 weeks after therapy. Results Fifteen of the 409 eyes (3.6%) developed RPE tear (95% confidence interval: 2.2-6.0, odds ratio: 26.3). The statistical modelling showed significant association between RPE tear and occult without classic CNV/predominantly haemorrhage vs predominantly/minimal classic CNV (P ¼ 0.019), as well as medium or large (44 disc area) vs small size of the total lesion (P ¼ 0.038). Previous treatment and status of the fellow eye did not statistically influence the risk of RPE tears. Conclusions An RPE tear can develop in up to 3.6% of eyes with neovascular AMD following single administration of intravitreal bevacizumab in a short-term follow-up. Medium and large lesion size and occult without classic and predominantly haemorrhagic subtype of CNV were important predictive factors. Preoperative assessment of the lesion characteristics may help in identifying the risk of individual patients with neovascular AMD before intravitreal bevacizumab treatment.

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Retinal Pigment Epithelial Tear following Intravitreal Injection of Bevacizumab (Avastin)

Abstract: This report describes the development of retinal pigment epithelium tear after intravitreal bevacizumab injection. Future studies should be performed to evaluate which subtypes of lesions are most susceptible to this potential devastating visual complication.

Cited by 45 publications

References 5 publications

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

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

Can the risk of retinal pigment epithelium tears after bevacizumab treatment be predicted? An optical coherence tomography study

Retinal pigment epithelial tears after single administration of intravitreal bevacizumab for neovascular age-related macular degeneration

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