Retinal Pigment Epithelium Tears in Age-Related Macular Degeneration Treated with Antiangiogenic Drugs: A Controlled Study with Long Follow-Up

Abstract

Purpose: To study whether anti-vascular endothelial growth factor (VEGF) therapy improves visual acuity (VA) in patients with exudative age-related macular degeneration (AMD) complicated with retinal pigment epithelium (RPE) tears. Methods: Retrospective case-control series. Group I (control group) included 9 patients with RPE tears that received no treatment, and group II (intervention group) incorporated 12 patients treated with anti-VEGF. Results: A statistically significant difference was found in VA between the groups from the 3rd month to the final follow-up (p = 0.034). Final VA improved in the treatment group (p = 0.015). No differences were found in central macular thickness between the groups either before or after treatment. Mean number of injections in group II was 5.75 (SD = 1.19). Most patients presented a grade 3 rip. All lesions were inactive at the end of follow-up in group II and 1 remained active in group I. The number of final atrophic/disciform scars was 6/8 in group I and 7/5 in group II. Conclusions: RPE tears treated with antiangiogenic drugs experienced functional benefit. To the authors’ knowledge, this is the first controlled series reporting effectiveness of suppression of neovascular activity with antiangiogenic treatment after RPE rip in AMD.

Retinal Pigment Epithelium Tears: Risk Factors, Mechanism and Therapeutic Monitoring

“…Final visual acuity was worse for larger RPE tears (grades 3 and 4) when compared with smaller tears (grades 1 and 2), which is in accordance with findings by Sarraf et al [24]. Similar functional results were reported by Coco et al [47]. Improvements in visual acuity have also been reported in patients with spontaneous RPE tears who were subsequently treated with anti-VEGF therapy [48].…”

Ocular and systemic safety of bevacizumab and ranibizumab in patients with neovascular age-related macular degeneration

“…They are commonly reported as adverse events in studies of patients undergoing intravitreal bevacizumab or ranibizumab injection [14 && ,29,31,32,37,40,42,47, 49,51,59,68,70]. In addition, neovascular AMD complicated by tears of RPE does improve with anti-VEGF therapy [99]. In addition, neovascular AMD complicated by tears of RPE does improve with anti-VEGF therapy [99].…”

One year results of anti-VEGF treatment in pigment epithelial detachment secondary to macular degeneration

“…In the literature, some publications reported a worsening of VA due to the occurrence of an RPE tear after the anti-VEGF injection. Other studies reported no change (20) . However, long-term follow-up of these patients is required and when deciding on the course of treat ment to use, possible complications should be considered.…”