Abstract
Purpose: :
To determine the factors and long-term outcomes of retinal pigment epithelial (RPE) tear after intravitreal anti-vascular endothelial growth factor (VEGF) and photodynamic therapy (PDT) for exudative age-related macular degeneration (AMD).
Methods: :
A total of 174 patients (175 eyes) who were treated by PDT combined with anti-VEGF for exudative AMD. They were diagnosed using fluorescein angiography (FA) and indocyanine green angiography, optical coherence tomography (SD-OCT), fundus autofluorescence (FAF). We evaluated subtypes of AMD, the shape of pigment epithelial detachment (PED), visual acuity and the final fundus findings.
Results: :
Seven eyes (4.0%) developed RPE tear following therapy. Before development of RPE tear, all the 7 eyes had occult CNV in FA and had tall fibrovascular PED in OCT. FAF showed absence of autofluorescense in the area of denuded RPE. The period between treatment and development of RPE tear was within 3 months in all cases. Final visual acuity was poor because RPE tear involved the fovea and remaining macular edema.
Conclusions: :
Tall fibrovascular PED may have a high risk of RPE tear.
Keywords: age-related macular degeneration • retinal pigment epithelium • photodynamic therapy