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Focal retinal pigment epithelium atrophy at the location of type 3 neovascularization lesion: a morphologic feature associated with low reactivation rate and favorable prognosis

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To investigate the clinical significance of focal retinal pigment epithelium (RPE) atrophy in the eyes with type 3 neovascularization.

Methods

This retrospective study included 184 eyes those were diagnosed with type 3 neovascularization and were treated with antivascular endothelial growth factor (VEGF) therapy. Focal RPE atrophy was defined as a localized RPE atrophy found at the same location as the type 3 lesion. The incidence of reactivation after 3 loading injections and the visual outcomes was compared between a focal RPE atrophy group and a nonfocal RPE atrophy group. In the focal RPE atrophy group, the number of injections was compared between before and after the development of RPE atrophy.

Results

The mean follow-up period was 37.6 ± 18.8 months; focal RPE atrophy developed in 24 eyes (13.0%). Reactivation of the lesion after 3 loading injections was significantly less frequent in the focal RPE atrophy group (58.3%) than that in the nonfocal RPE atrophy group (85.0%) (P = 0.004). In the focal RPE atrophy group, the mean best-corrected visual acuity (BCVA) was 0.68 ± 0.28 (Snellen equivalent = 20/95) at diagnosis and 0.70 ± 0.48 (20/100) at the final follow-up. In the nonfocal RPE atrophy group, the values were 0.75 ± 0.34 (20/112) and 1.12 ± 0.68 (20/263), respectively. The BCVA at the final follow-up was significantly better in the focal RPE atrophy group (P < 0.001). The mean number of injections per year was 4.9 ± 1.8 and 1.3 ± 1.6 before and after the development of focal RPE atrophy, respectively (P < 0.001).

Conclusions

Development of focal RPE atrophy was associated with a low incidence of reactivation of type 3 neovascularization and was therefore predictive of a favorable visual prognosis.

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Funding

Kim’s Eye Hospital (Seoul, South Korea) provided financial support in the form of funding for English editing support.

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Authors and Affiliations

  1. Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, #156 Yeongdeungpo-dong 4-ga, Yeongdeungpo-gu, Seoul, 150-034, South Korea

    Jae Hui Kim, Jong Woo Kim, Chul Gu Kim & Dong Won Lee

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  1. Jae Hui Kim
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Correspondence to Jae Hui Kim.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the institutional review board of Kim’s Eye Hospital (Seoul, South Korea). This study was conducted in accordance with the tenets of the Declaration of Helsinki.

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Informed consent was not obtained in this study. Identifying information about participants was not presented in this study.

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Kim, J.H., Kim, J.W., Kim, C.G. et al. Focal retinal pigment epithelium atrophy at the location of type 3 neovascularization lesion: a morphologic feature associated with low reactivation rate and favorable prognosis. Graefes Arch Clin Exp Ophthalmol 257, 1661–1669 (2019). https://doi.org/10.1007/s00417-019-04373-4

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  • DOI: https://doi.org/10.1007/s00417-019-04373-4

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