2M.D. Professor, Gazi University, Faculty of Medicine, Department of Ophthalmology, Ankara/TURKEY
3M.D. Asistant Professor, Yıldırım Beyazıt University, Department of Biostatistics, Ankara/TURKEY Purpose: To evaluate the effect of vascular endothelial growth factor (VEGF) inhibition on vascularized pigment epithelium detachment (vPED) associated with exudative age-related macular degeneration (AMD).
Material and Methods: The records of patients with exudative AMD associated with vPED who have been treated with anti-VEGFs were reviewed for outcome of measures to determine the effects of treatment on the lesion characteristics and vPED dimensions. Best corrected visual acuity (BCVA), central foveal thickness (CFT) and vPED height measurements in optical coherence tomography (OCT) were recorded for each eye. Fluorescein angiography (FA)was performed initially and as needed thereafter to determine the lesion characteristics and PED diameter.
Results: One hundred and six eyes of 96 patients were included in the study. All of the patients had received three loading doses of anti-VEGF followed by PRN (pro re nata) (as needed) dosing regimen. The mean follow-up time was 22.4±2.3months (20-35mo).The mean number of anti-VEGF injections was 8.5±2.3 (4-12). The best-corrected visual acuity (BCVA) did not vary significantly; the central foveal thickness (CFT), PED height, and PED diameters decreased significantly at the end of follow-up. Complete resolution of PED was noted only in 21.6% of eyes; persistence of PED was observed in 78.4% of eyes. The persistence or resolution of PED in response to treatment did not correlate with the final visual acuity. Twenty one out of 106 eyes (19.8%) developed retina pigment epithelium (RPE) tear.
Conclusions: This retrospective study showed that intravitreal anti-VEGF therapy for vPED preserved vision and reduced PED height and diameter; also demonstrated that the anatomical response of the PED may not correlate directly with the visual outcome.
Keywords : related macular degeneration, anti-VEGF treatment,choroidal neovascularization, pigment epithelial detachment