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A.A. Izad, B.K. Rutledge, S.C. Spalding, III, G.R. Hampton, P.F. Torrisi; Prevalence of Retinal Pigment Epithelial Tears Following Photodynamic Therapy for Choroidal Neovascularization Associated With Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2184.
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To study the prevalence of retinal pigment epithelial tears associated with photodynamic therapy for choroidal neovascularization in age–related macular degeneration, and to characterize the associated lesion type and visual outcome in these cases.
Review of medical records and the fluorescein angiograms of all consecutive patients with neovascular age–related macular degeneration who received photodynamic therapy from June 2000 to October 2004.
Among 834 patients (900 eyes) who underwent photodynamic therapy, ten patients (11 eyes) developed retinal pigment epithelial tears. Prevalence was 1.22%. Each patient underwent 1 to 4 treatments (mean, 1.6). Duration of follow–up was 3 to 41 months (mean, 17 months). Nine treated eyes (82%) presented with occult choroidal neovascularization, one eye (9%) with minimally classic and one eye (9%) exhibited only classic component upon initial presentation. All eyes with predominantly occult choroidal neovascularization were of fibrovascular type with pigment epithelial detachment. The only eye with principally classic component presented with an element of serous pigment epithelial detachment. Six eyes (55%) lost 3 or more Snellen lines of visual acuity, 2 eyes (18%) lost 1 to 2 lines, and 3 eyes (27%) had no change in visual acuity upon diagnosis of the retinal pigment epithelial tear.
Retinal pigment epithelial tears developed with a prevalence of 1.22% in this series. 91% of 11 eyes presented with predominantly occult choroidal neovascularization prior to photodynamic therapy. All tears were associated with pigment epithelial detachment. Significant visual loss of 3 or more Snellen visual acuity lines occurred in 55% of eyes following development of retinal pigment epithelial tears. Severe visual loss to counting finger occurred in 3 eyes, all of which demonstrated occult choroidal neovascularization. Although retinal pigment epithelial tears following photodynamic therapy appears to be uncommon, patients should be cautioned that this is another potential complication following treatment that could lead to further visual loss.
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