Wrinkled Vascularized Retinal Pigment Epithelium Detachment Prognosis After Intravitreal Anti-Vascular Endothelial Growth Factor Therapy

Lam, Delphine; Semoun, Oudy; Blanco-Garavito, Rocío; Jung, Camille; Nguyen, Diem Trang; Souied, Eric H.; Mimoun, G.

doi:10.1097/iae.0000000000001698

Cited by 9 publications

(5 citation statements)

References 50 publications

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“…Particularly, they found the growth in PEDs' greatest linear diameter to be associated with the maintenance of a quiescent phenotype, whereas the growth in PEDs' maximal height was associated more frequently with the development of an exudative phenotype. The latter was confirmed by studies by Lam et al [44] and Serra et al [43]. These suggest that PEDs' "contour" morphology might be indicative of a possible future exudative development.…”

Section: Discussionsupporting

confidence: 56%

Biomarkers in Early Response to Brolucizumab on Pigment Epithelium Detachment Associated with Exudative Age-Related Macular Degeneration

Rispoli

Eandi

Antonio³

et al. 2021

Biomedicines

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Background: The purpose of this study was to describe early changes in the morphology of pigment epithelium detachments (PED) after an intravitreal injection of Brolucizumab into eyes with macular neovascularization secondary to exudative age-related macular degeneration (e-AMD). Method: We included twelve eyes of 12 patients with PED secondary to e-AMD which were not responding to prior anti-VEGF treatments. An ophthalmic examination and an assessment of PED-horizontal maximal diameter (PED-HMD), PED-maximum high (PED-MH) and macular neovascularization (MNV) flow area (MNV-FA) by the means of structural optical coherence tomography (OCT) and OCT Angiography (OCT-A) were performed at baseline, as well as 1, 7, 14 and 30 days after the injection. Results: The mean age of the population of study was 78.4 (SD ± 4.8). The mean number of previous Ranibizumab or Aflibercept injections was 13 (SD ± 8). At the last follow-up visit, the PED-HMD did not significantly change (p = 0.16; F(DF:1.94, 20,85) = 1.9), the PED-MH showed a significant reduction [p = 0.01; F(DF:1.31, 14.13) = 6.84.] and the MNV-FA did not significantly differ (p = 0.1; F(1.97, 21.67) = 2.54) from baseline. No signs of ocular inflammation were observed during follow-up. Conclusions: A single Brolucizumab injection was able to determine the short-term effects on PEDs’ anatomical features of eyes with an unresponsive e-AMD.

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Section: Discussionsupporting

confidence: 56%

Biomarkers in Early Response to Brolucizumab on Pigment Epithelium Detachment Associated with Exudative Age-Related Macular Degeneration

Rispoli

Eandi

Antonio³

et al. 2021

Biomedicines

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“…In addition, in our study, brolucizumab was also efficacious in reducing PED height that significantly decreased during follow-up ( p = 0.020), thus confirming the possible role of PED as a biomarker. Different authors found a connection between the growing PED horizontal diameter and the maintenance of a quiescent CNV type, whereas the increase in vertical diameter being related to an exudative state, reinforcing possible use of PED as a biomarker [31, 32].…”

Section: Discussionmentioning

confidence: 99%

Brolucizumab Intravitreal Injection in Macular Neovascularization Type 1: VA, SD-OCT, and OCTA Parameter Changes during a 16-Week Follow-Up

et al. 2022

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Purpose: to assess the anatomical and functional changes after brolucizumab intravitreal injection (BIVI) in macular neovascularization type 1 (MNV1). Setting/Venue: Ophthalmology Clinic, University "G. d'Annunzio" of Chieti-Pescara. Methods: A total of 24 eyes of 24 patients suffering from naïve MNV1 candidates to BIVI as per label with q12/q8 dosing regimen after the loading dose were enrolled in this prospective study. Main outcome measures during a 16-weeks follow up period included changes of best corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal subretinal fluid thickness (SSRFT), subfoveal sub-RPE fluid thickness (SSRPEFT), subfoveal choroidal thickness (SFCT) and pigment epithelial detachment (PED) maximum height (PED-MH). In addition, percentages of eyes with intraretinal fluid, subretinal fluid and sub-RPE fluid at different time points and percentages of eyes candidates to a q8 or q 12 injection interval after disease activity assessment at week 16 were evaluated. Results: BCVA improved significantly from baseline (T0) to week 12 (T3) (p=0.028). CMT showed a significant reduction from 456.0±123.0 µm at T0 to 265.0±85.0 µm at T3 (p<0.001). SSRFT and SSRPEFT reduced significantly as well (p<0.001 and p=0.049 respectively). PED-MH reduced significantly from 162.0±110.0 µm at T0 to 94.1±38.9 µm at T3 (p=0.020) and SFCT from 203.0±56.9 µm at T0 to 146.0±64.2 µm at T3 (p=0.006). IRF presence changed significantly from 41.7% of eyes at T0 to 20.8% at T3 (p=0.045). SSRF reduced significantly during follow up, being present in 62.5% of eyes at T0 and 4.2% of eyes at T3 (p<0.001). Subfoveal sub-RPE fluid decreased significantly during time being present in 20.8% of eyes at T0 and 0% at T3 (p=0.013). Most of the eyes (18 eyes, 75%) at week 16 after disease activity assessment were shifted in the q12 interval and only a minority of eyes shifted in a q8 interval (6 eyes, 25%). CC Flow and ORCC flow did not show significant differences during follow up. Conclusions: Brolucizumab is efficient in reducing all retinal fluids during the loading phase and shows reduction of macular thickness, choroidal thickness, and PED height. Most eyes at disease activity assessment (75%) fall into 12 week-interval and the minority (25%) into the 8 week-interval.

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“…13,[31][32][33] Reduction in fibrovascular PED height in this context may be the result of fibrocytes and other inflammatory cells that contract, as evidenced by the presence of overlying RPE wrinkling. 34 Vascularized serous PEDs that acutely collapse because of VEGF-mediated reduction of fluid and leakage may transition to a chronic multilayered fibrovascular PED after chronic therapy.…”

Section: Discussionmentioning

confidence: 99%

Volumetric Analysis of Vascularized Serous Pigment Epithelial Detachment Progression in Neovascular Age-Related Macular Degeneration Using Optical Coherence Tomography Angiography

Hou

Dávila

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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Wrinkled Vascularized Retinal Pigment Epithelium Detachment Prognosis After Intravitreal Anti-Vascular Endothelial Growth Factor Therapy

Cited by 9 publications

References 50 publications

Biomarkers in Early Response to Brolucizumab on Pigment Epithelium Detachment Associated with Exudative Age-Related Macular Degeneration

Biomarkers in Early Response to Brolucizumab on Pigment Epithelium Detachment Associated with Exudative Age-Related Macular Degeneration

Brolucizumab Intravitreal Injection in Macular Neovascularization Type 1: VA, SD-OCT, and OCTA Parameter Changes during a 16-Week Follow-Up

Volumetric Analysis of Vascularized Serous Pigment Epithelial Detachment Progression in Neovascular Age-Related Macular Degeneration Using Optical Coherence Tomography Angiography

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