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Albert Caramoy, Bernd Kirchhof, Sascha Fauser; Retrospective Analysis Of Retinal Pigment Epithelium Tears With And Without Pro Re Nata Anti-VEGF Treatments. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5147.
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Studying, retrospectively, the progression of retinal pigment epithelium (RPE) tears secondary to age-related macular degeneration (AMD).
Retrospective chart analysis of 82 eyes with RPE tears. RPE tears were diagnosed mainly using fluorescein angiography. Distant and reading visual acuities, optical coherence tomography, fluorescein angiography, and fundus examination were performed. Far visual acuity (FVA) and reading visual acuity (RVA) were converted into LogMAR. The extent of scar formation over time and the degree of RPE tears were graded.
Twenty seven men and 55 women were included in the analysis. The mean follow-up time was 609 days. Grade of RPE tears correlated neither with FVA nor with RVA (r=0.16, p=0.21 and r= 0.20, p=0.15, respectively). Patients receiving anti vascular endothelial growth factor (anti-VEGF) treatment maintained stable FVA for some extent, however RVA worsened over time (FVA 0.66 vs. 0.82 LogMAR, p=0.067 and RVA 0.81 vs. 1.36 LogMAR, p=0.018). Scar formation progresses despite pro re nata anti-VEGF treatment. In patients receiving no therapy VA was inferior at baseline and remained inferior at the last follow up (FVA 1.12 vs. 1.27 LogMAR, p=0.029 and RVA 1.49 vs. 1.65 LogMAR, p=0.082). Three eyes showed retracting RPE over time even under anti-VEGF treatment. Seven of 19 patients receiving anti-VEGF therapy on pro re nata regiment showed decrease of VA more than 2 lines.
Continuing or initiating anti-VEGF therapy after RPE tears may help stabilize the FVA to some extent and slow down scar formation. In the long term pro re nata anti-VEGF treatment cannot influence the worsening of RVA. Retracting RPE remains unsolved with anti-VEGF treatment.
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