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ADDITIONAL ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR EYES WITH A RETINAL PIGMENT EPITHELIAL TEAR AFTER THE INITIAL THERAPY

Asao, Kazunobu MD*; Gomi, Fumi MD*,†; Sawa, Miki MD*; Nishida, Kohji MD*

doi: 10.1097/IAE.0b013e31829f73eb
Original Study

Purpose: To evaluate the effects of additional anti–vascular endothelial growth factor (VEGF) therapy for eyes with a retinal pigment epithelial (RPE) tear after anti-VEGF therapy and treated with additional anti-VEGF injections for recurrent or persistent exudative change.

Patients and Methods: Ten eyes (10 patients) followed up for >12 months after a recurrent RPE tear were evaluated retrospectively. The RPE tears on fundus autofluorescence images were measured and changes in the best-corrected visual acuity were evaluated.

Results: Patients were followed up for >12 months (mean, 27.3; range, 13–44 months). During 12 months of follow-up, additional anti-VEGF injections (mean, 3.3; range, 1–7) were administered. The mean size of the RPE tear at the onset was 6.5 mm2 (range, 1.3–16.3 mm2). At 12 months, the RPE tear increased in size >20% in 5 eyes and remained unchanged or decreased in the remaining half of eyes. The mean logarithm of the minimum angle of resolution best-corrected visual acuity was 0.43 at the time the RPE tear developed and 0.85 at 12 months. The RPE tear grade and age were prognostic factors for best-corrected visual acuity at 12 months.

Conclusion: Under continued anti-VEGF therapy, RPE tears may be stable in size and visual acuity could be maintained in some eyes; however, the visual acuity prognosis is still unsatisfactory in nonresponsive eyes.

Retinal pigment epithelial tears after anti–vascular endothelial growth factor therapy may be stable in size, and visual acuity could be maintained with continuous anti–vascular endothelial growth factor treatment, although the visual acuity prognosis is still unsatisfactory in nonresponsive eyes.

*Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan; and

Department of Ophthalmology, Sumitomo Hospital, Osaka, Japan.

Reprint requests: Fumi Gomi, MD, Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; e-mail: gomi.fumi@gmail.com

All patients provided the written informed consent for the treatment. The study adhered to the tenets of the Declaration of Helsinki.

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.