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Takayuki Baba, Masayasu Kitahashi, Mariko Kubota-Taniai, Emi Ohoka, Shuichi Yamamoto; Two-year Follow-up Of Subfoveal Pigment Epithelial Detachment In Eyes With Age-related Macular Degeneration And Visual Acuity Better Than 20/40. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1679.
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To investigate the clinical course of subfoveal pigment epithelial detachments (PEDs) in eyes with age-related macular degeneration (AMD) and visual acuity better than 20/40.
Retrospective interventional case series. Thirty-seven eyes of 35 cases (men 29, women 6) were studied. The mean age of the patients was 67.7 years with a range from 53 to 81 years. This study was approved by the Institutional Review Board, and an informed consent was obtained from every patient. All cases had a subfoveal PED larger than one disc area, and all were diagnosed with exudative AMD. The cases were divided into three groups by the type of PED; non-vascularized PED (Group A, 14 eyes), vascularized PED including polypoidal vasculopathy (PCV, Group B, 15 eyes), and occult choroidal neovascularization (CNV, Group C, 8 eyes). The best-corrected visual acuity (BCVA) was better than 20/40 in all eyes with a range of 20/20-20/40 (median, 20/30). The eyes were treated with intravitreal bevacizumab or ranibizumab when the BCVA decreased or metamorphopsia increased. The BCVA, central foveal thickness (CFT), and PED thickness measured by FD-OCT at baseline were compared to that two years after the initial presentation.
The BCVA did not change in Group A, decreased from 0.06±0.11 to 0.33±0.50 logMAR units in Group B, and decreased from 0.09±0.12 to 0.67±0.79 logMAR units in Group C. The CFT and PED thickness did not change significantly in all groups. However, the number of cases with a completely resolved PED was significantly larger in Group B (5 cases, P=0.014). The number of cases requiring treatment was highest in Group C (7 cases, P=0.022). The mean number of injection was 3.0 in Group A, 4.0 in Group B, and 3.0 in Group C.
The BCVA is maintained in cases with non-vasucularized PED regardless of the duration of the PED, while one-half of the cases with vascularized PEDs had BCVA worse than 20/40 at the two year follow-up. The clinical course of subfoveal vascularized PEDs with good BCVA is different from that in eyes with non-vascularized PEDs.
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