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S. J. Garg, D. H. Fischer, C. Shah, J. Hsu, R. Kaiser, M. Spirn; Tears of the Retinal Pigment Epithelium Following Intravitreal Injections of Bevacizumab for Exudative Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1788.
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To determine the risk factors for the development of tears of the retinal pigment epithelium after intravitreal bevacizumab injections.
We identified five eyes of five patients in which a retinal pigment epithelial tear developed following an intravitreal bevacizumab injection for the treatment of exudative age-related macular degeneration. No patient had prior treatment for exudative macular degeneration in the affected eye. All 5 patients received 0.05 cc of intravitreal bevacizumab per injection.
The patients returned to the clinic after developing sudden vision loss within days of their most recent injection (between injection numbers 1 to 3). The mean visual acuity before the retinal pigment epithelial tear was 20/200, and decreased to a mean of 20/800 after the tear. Three eyes had a large serous pigment epithelial detachment at baseline. Two patients had persistent leakage of fluid on angiography and continued to receive intravitreal injections of bevacizumab.
Tears of the retinal pigment epithelium can be a visually devastating complication of intravitreal bevacizumab injections. A large, serous pigment epithelial detachment may predispose patients to the development of this condition.
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