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Pigment epithelial tears after ranibizumab injection in polypoidal choroidal vasculopathy and typical age-related macular degeneration

  • Retinal Disorders
  • Published:
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Abstract

Purpose

The purpose of the study was to compare the rates and characteristics of retinal pigment epithelial (RPE) tears between typical exudative age-related macular degeneration (tAMD) and polypoidal choroidal vasculopathy (PCV) after injection of intravitreal ranibizumab (IVR).

Methods

In total, 836 eyes from 784 patients with exudative AMD treated with IVR were analyzed. The presence, type, size, and height of pigment epithelial detachment (PED) in OCT before injection were evaluated, and the occurrence rate of RPE tears within three months of injection between tAMD and PCV was compared.

Results

In total, 515 eyes (61.6 %) had tAMD and 321 eyes (38.4 %) were diagnosed as PCV. RPE tears developed in 18 eyes (3.5 %) in the tAMD group, while only two eyes (0.62 %) were associated with PCV (p = 0.009, Chi-square test). Eleven of the eighteen eyes with RPE tears in tAMD had fibrovascular PED with contractile neovascular tissue under the surface of the RPE and a cleft at baseline. Two eyes with RPE tears in PCV showed large hemorrhagic PED before presenting with an RPE tear.

Conclusions

RPE tears after IVR were significantly less common in PCV than in tAMD. The different characteristics of RPE tears between the two disease entities suggest differences in the pathogenesis underlying the event.

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References

  1. Hoskin A, Bird AC, Sehmi K (1981) Tears of detached retinal pigment epithelium. Br J Ophthalmol 65:417–422

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Chang LK, Sarraf D (2007) Tears of the retinal pigment epithelium: an old problem in a new era. Retina 27:523–534

    Article  PubMed  Google Scholar 

  3. Pauleikhoff D, Löffert D, Spital G et al (2002) Pigment epithelial detachment in the elderly. Clinical differentiation, natural course and pathogenetic implications. Graefes Arch Clin Exp Ophthalmol 240:533–538

    Article  CAS  PubMed  Google Scholar 

  4. Clemens CR, Bastian N, Alten F et al (2014) Prediction of retinal pigment epithelial tear in serous vascularized pigment epithelium detachment. Acta Ophthalmol 92:e50–e56

    Article  CAS  PubMed  Google Scholar 

  5. Chiang A, Chang LK, Yu F, Sarraf D (2008) Predictors of anti-VEGF-associated retinal pigment epithelial tear using FA and OCT analysis. Retina 28:1265–1269

    Article  PubMed  Google Scholar 

  6. Chan CK, Abraham P, Meyer CH et al (2010) Optical coherence tomography-measured pigment epithelial detachment height as a predictor for retinal pigment epithelial tears associated with intravitreal bevacizumab injections. Retina 2010(30):203–211

    Article  Google Scholar 

  7. Leitritz M, Gelisken F, Inhoffen W et al (2008) Can the risk of retinal pigment epithelium tears after bevacizumab treatment be predicted? An optical coherence tomography study. Eye 22:1504–1507

    Article  CAS  PubMed  Google Scholar 

  8. Gelisken F, Ziemssen F, Voelker M et al (2009) Retinal pigment epithelial tears after single administration of intravitreal bevacizumab for neovascular age-related macular degeneration. Eye 23:694–702

    Article  CAS  PubMed  Google Scholar 

  9. Tsujikawa A, Hirami Y, Nakanishi H et al (2007) Retinal pigment epithelial tear in polypoidal choroidal vasculopathy. Retina 2007(27):832–838

    Article  Google Scholar 

  10. Gomi F, Tano Y (2008) Polypoidal choroidal vasculopathy and treatments. Curr Opin Ophthalmol 19:208–212

    Article  PubMed  Google Scholar 

  11. Tsujikawa A, Sasahara M, Otani A et al (2007) Pigment epithelial detachment in polypoidal choroidal vasculopathy. Am J Ophthalmol 143:102–111

    Article  PubMed  Google Scholar 

  12. Oishi A, Kojima H, Mandai M et al (2013) Comparison of the effect of ranibizumab and verteporfin for polypoidal choroidal vasculopathy: 12-month LAPTOP study results. Am J Ophthalmol 156:644–651

    Article  CAS  PubMed  Google Scholar 

  13. Koh A, Lee WK, Chen L-J et al (2012) EVEREST study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina 32:1453–1464

    Article  CAS  PubMed  Google Scholar 

  14. Sarraf D, Reddy S, Chiang A et al (2010) A new grading system for retinal pigment epithelial tears. Retina 30:1039–1045

    Article  PubMed  Google Scholar 

  15. Konstantinidis L, Ambresin A, Zografos L, Mantel I (2010) Retinal pigment epithelium tears after intravitreal injection of ranibizumab for predominantly classic neovascular membranes secondary to age-related macular degeneration. Acta Ophthalmol 88:736–741

    Article  PubMed  Google Scholar 

  16. Smith BT, Kraus CL, Apte RS (2009) Retinal pigment epithelial tears in ranibizumab-treated eyes. Retina Phila Pa 29:335–339. doi:10.1097/IAE.0b013e318195cad5

    Article  Google Scholar 

  17. Cunningham ET Jr, Feiner L, Chung C et al (2011) Incidence of retinal pigment epithelial tears after intravitreal ranibizumab injection for neovascular age-related macular degeneration. Ophthalmology 118:2447–2452

    Article  PubMed  Google Scholar 

  18. Doguizi S, Ozdek S (2014) Pigment epithelial tears associated with anti-VEGF therapy: incidence, long-term visual outcome, and relationship with pigment epithelial detachment in age-related macular degeneration. Retina 34:1156–1162

    Article  CAS  PubMed  Google Scholar 

  19. Spaide RF (2009) Enhanced depth imaging optical coherence tomography of retinal pigment epithelial detachment in age-related macular degeneration. Am J Ophthalmol 147:644–652

    Article  PubMed  Google Scholar 

  20. Gibran SK, Sachdev A, Stappler T et al (2007) Histological findings of a choroidal neovascular membrane removed at the time of macular translocation in a patient previously treated with intravitreal bevacizumab treatment (Avastin). Br J Ophthalmol 91:602–604

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Arevalo JF, Maia M, Flynn HW Jr et al (2008) Tractional retinal detachment following intravitreal bevacizumab (Avastin) in patients with severe proliferative diabetic retinopathy. Br J Ophthalmol 92:213–216

    Article  CAS  PubMed  Google Scholar 

  22. Nagiel A, Freund KB, Spaide RF et al (2013) Mechanism of retinal pigment epithelium tear formation following intravitreal anti-vascular endothelial growth factor therapy revealed by spectral-domain optical coherence tomography. Am J Ophthalmol 156:981–988

    Article  CAS  PubMed  Google Scholar 

  23. Toth CA, Pasquale AC 3rd, Graichen DF (1995) Clinicopathologic correlation of spontaneous retinal pigment epithelial tears with choroidal neovascular membranes in age-related macular degeneration. Ophthalmology 102:272–277

    Article  CAS  PubMed  Google Scholar 

  24. Carvounis PE, Kopel AC, Benz MS (2007) Retinal pigment epithelium tears following ranibizumab for exudative age-related macular degeneration. Am J Ophthalmol 143:504–505

    Article  CAS  PubMed  Google Scholar 

  25. Iijima H, Imai M, Gohdo T, Tsukahara S (1999) Optical coherence tomography of idiopathic polypoidal choroidal vasculopathy. Am J Ophthalmol 127:301–305

    Article  CAS  PubMed  Google Scholar 

  26. Khan S, Engelbert M, Imamura Y, Freund KB (2012) Polypoidal choroidal vasculopathy: simultaneous indocyanine green angiography and eye-tracked spectral domain optical coherence tomography findings. Retina 32:1057–1068

    Article  PubMed  Google Scholar 

  27. MacCumber MW, Dastgheib K, Bressler NM et al (1994) Clinicopathologic correlation of the multiple recurrent serosanguineous retinal pigment epithelial detachments syndrome. Retina 14:143–152

    Article  CAS  PubMed  Google Scholar 

  28. Terasaki H, Miyake Y, Suzuki T et al (2002) Polypoidal choroidal vasculopathy treated with macular translocation: clinical pathological correlation. Br J Ophthalmol 86:321–327

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. Lafaut BA, Aisenbrey S, Van den Broecke C et al (2000) Polypoidal choroidal vasculopathy pattern in age-related macular degeneration: a clinicopathologic correlation. Retina 20:650–654

    CAS  PubMed  Google Scholar 

  30. Tong J-P, Chan W-M, Liu DTL et al (2006) Aqueous humor levels of vascular endothelial growth factor and pigment epithelium-derived factor in polypoidal choroidal vasculopathy and choroidal neovascularization. Am J Ophthalmol 141:456–462

    Article  CAS  PubMed  Google Scholar 

  31. Nakashizuka H, Mitsumata M, Okisaka S et al (2008) Clinicopathologic findings in polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci 49:4729–4737

    Article  PubMed  Google Scholar 

  32. Nakajima M, Yuzawa M, Shimada H, Mori R (2004) Correlation between indocyanine green angiographic findings and histopathology of polypoidal choroidal vasculopathy. Jpn J Ophthalmol 48:249–255

    Article  PubMed  Google Scholar 

  33. Musashi K, Tsujikawa A, Hirami Y et al (2007) Microrips of the retinal pigment epithelium in polypoidal choroidal vasculopathy. Am J Ophthalmol 143:883–885

    Article  PubMed  Google Scholar 

  34. Shiraga F, Matsuo T, Yokoe S et al (1999) Surgical treatment of submacular hemorrhage associated with idiopathic polypoidal choroidal vasculopathy. Am J Ophthalmol 128:147–154

    Article  CAS  PubMed  Google Scholar 

  35. Gass JD (1984) Pathogenesis of tears of the retinal pigment epithelium. Br J Ophthalmol 68:513–519

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  36. Ie D, Yannuzzi LA, Spaide RF et al (1992) Microrips of the retinal pigment epithelium. Arch Ophthalmol 110:1443–1449

    Article  CAS  PubMed  Google Scholar 

  37. Goldstein BG, Pavan PR (1987) “Blow-outs” in the retinal pigment epithelium. Br J Ophthalmol 71:676–681

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Meyer CH, Toth CA (2001) Retinal pigment epithelial tear with vitreomacular attachment: a novel pathogenic feature. Graefes Arch Clin Exp Ophthalmol 239:325–333

    Article  CAS  PubMed  Google Scholar 

  39. Gamulescu MA, Framme C, Sachs H (2006) RPE-rip after intravitreal bevacizumab (Avastin) treatment for vascularised PED secondary to AMD. Graefes Arch Clin Exp Ophthalmol 245:1037–1040

    Article  Google Scholar 

  40. Sarraf D, Chan C, Rahimy E, Abraham P (2013) Prospective evaluation of the incidence and risk factors for the development of RPE tears after high- and low-dose ranibizumab therapy. Retina 33(8):1551–1557

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2013R1A1A2007865)

Conflict of interest statement

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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Authors and Affiliations

  1. The Institute of Vision Research, Severance Hospital, Department of Ophthalmology, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul, Korea, 120-752

    Joo Youn Shin, Moonjung Choi, Byunghoon Chung & Suk Ho Byeon

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  1. Joo Youn Shin
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  2. Moonjung Choi
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Correspondence to Suk Ho Byeon.

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Shin, J.Y., Choi, M., Chung, B. et al. Pigment epithelial tears after ranibizumab injection in polypoidal choroidal vasculopathy and typical age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 253, 2151–2160 (2015). https://doi.org/10.1007/s00417-015-2977-3

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  • DOI: https://doi.org/10.1007/s00417-015-2977-3

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