Change in vision after retinal pigment epithelium tear following the use of anti-VEGF therapy for age-related macular degeneration

  • Shane R. Durkin
  • Lachlan D. M. Farmer
  • Susith Kulasekara
  • Jagjit Gilhotra
Retinal Disorders

Abstract

Purpose

We investigated visual acuity outcomes and their associations in the setting of retinal pigment epithelium tear (RPET) following the use of anti-vascular endothelial growth factor (anti-VEGF) agents.

Methods

This retrospective review included all patients treated for neovascular age-related macular degeneration (AMD) with an anti-VEGF agent who subsequently developed an RPET. All patients who developed an RPET were identified and outcome measures data were recorded and analysed. The main outcome measures were best corrected visual acuity (BCVA) and spectral domain optical coherence tomography characteristics.

Results

Among the 14 participants identified, a subfoveal RPET was associated with the loss of one or more lines of vision from baseline (p = 0.03). There was no association between the size of the RPET and BCVA at the time of the RPET or final BCVA. The development of a disciform scar was associated both with a BCVA at the time of the RPET of < 6/24 (p = 0.02) and a final BCVA of < 6/24 (p = 0.02). Ongoing treatment with an anti-VEGF agent following an RPET saw five patients (35.7 %) have an improvement in their BCVA and all patients maintained their BCVA following the RPET with ongoing anti-VEGF treatment.

Conclusions

Visual decline following an RPET is associated with subfoveal location of the RPET (p = 0.03) and later development of a disciform scar. These data also suggest that the ongoing use of an anti-VEGF agent may stabilise vision in some patients following an RPET and for some patients there may be an improvement in visual acuity despite the RPET, depending on its location.

Keywords

Bevacizumab Ranibizumab Retinal pigment epithelium Rip Tear Visual acuity 

Notes

Conflict of interest

All authors certify that they have no affiliations with, or involvement in, any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Shane R. Durkin
    • 1
    • 3
  • Lachlan D. M. Farmer
    • 1
  • Susith Kulasekara
    • 2
  • Jagjit Gilhotra
    • 1
    • 3
  1. 1.Discipline of Ophthalmology and Visual ScienceThe University of AdelaideAdelaideAustralia
  2. 2.Vitreoretina Fellow, Department of OphthalmologyRoyal Adelaide HospitalAdelaideAustralia
  3. 3.Adelaide Eye and Retina CentreAdelaideAustralia

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