May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Predictors of AntiVEGF-Associated Retinal Pigment Epithelial Tear Using OCT and FA Analysis
Author Affiliations & Notes
  • A. Chiang
    Ophthalmology, Jules Stein Eye Inst UCLA, Los Angeles, California
  • L. K. Chang
    Ophthalmology, Jules Stein Eye Inst UCLA, Los Angeles, California
  • F. Yu
    Ophthalmology, Jules Stein Eye Inst UCLA, Los Angeles, California
  • D. Sarraf
    Ophthalmology, Jules Stein Eye Inst UCLA, Los Angeles, California
    Ophthalmology, Kaiser Permanente Medical Center, Woodland Hills, California
  • Footnotes
    Commercial Relationships  A. Chiang, None; L.K. Chang, None; F. Yu, None; D. Sarraf, None.
  • Footnotes
    Support  RPB grant to Dr. David Sarraf
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 5070. doi:https://doi.org/
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    • Get Citation

      A. Chiang, L. K. Chang, F. Yu, D. Sarraf; Predictors of AntiVEGF-Associated Retinal Pigment Epithelial Tear Using OCT and FA Analysis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5070. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To identify optical coherence tomography (OCT) and fluorescein angiography (FA) predictors for retinal pigment epithelial (RPE) tear in eyes with pigment epithelium detachment (PED) associated with neovascular age-related macular degeneration (AMD) treated with intravitreal vascular endothelial growth factor (VEGF) modulating therapy.

Methods: : In an institutional setting, sixty consecutive patients with PED in the setting of neovascular AMD treated with VEGF modulating therapy (either pegaptanib, bevacizumab, or ranibizumab) over a 27-month period were included in the study. FA and OCT imaging was performed prior to and following antiVEGF therapy. Formal statistical analysis comparing the tear group to the non-tear group was performed to identify high-risk features for RPE tear.

Results: : RPE tear rate for eyes with vascularized PED receiving antiVEGF therapy was 17% (10/60). There were highly statistically significant differences in the median PED size on FA (greatest linear diameter) (3.2 mm vs. 1.8 mm, respectively; P<0.001) and in the median maximum PED height on OCT (394 um vs. 149 um, respectively; P=0.001) between the tear group and non-tear group. There was also a significant difference in terms of the presence of subretinal fluid on OCT between the two groups (87.5% vs. 39%, respectively; P=0.019).

Conclusions: : Large PED basal diameter and vertical height are correlated with an increased risk of developing an RPE tear following antiVEGF therapy. Patients with large vascularized PED by FA and/or OCT analysis should be alerted of the risk for vision loss due to RPE tear following antiVEGF therapy.

Keywords: retinal pigment epithelium • age-related macular degeneration • vascular endothelial growth factor 
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