Original StudyQUANTITATIVE CHANGES IN RETINAL PIGMENT EPITHELIAL DETACHMENTS AS A PREDICTOR FOR RETREATMENT WITH ANTI-VEGF THERAPYPenha, Fernando M. MD, PhD; Gregori, Giovanni PhD; Garcia Filho, Carlos Alexandre de Amorim MD; Yehoshua, Zohar MD; Feuer, William J. MS; Rosenfeld, Philip J. MD, PhDAuthor Information Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida. Reprint requests: Philip J. Rosenfeld, MD, PhD, Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, 900 NW 17th Street, Miami, FL 33136; e-mail: [email protected] Supported by a grant from the Carl Zeiss Meditec, Inc, Dublin, CA, and an unrestricted grant from the Research to Prevent Blindness, Inc, NEI core center grant P30 EY014801 to the University of Miami, the Jerome A. Yavitz Charitable Foundation, the Macula Vision Research Foundation, Feig Family Foundation, the Gemcon Family Foundation, the Carl and Lily Pforzheimer Foundation, and the Emma Clyde Hodge Memorial Foundation. The authors have no conflicts of interest to disclose. Retina: March 2013 - Volume 33 - Issue 3 - p 459-466 doi: 10.1097/IAE.0b013e31827d2657 Buy Metrics AbstractIn Brief Purpose: To determine if quantitative changes in retinal pigment epithelial detachments (PEDs) predict the need for retreatment in eyes undergoing spectral domain optical coherence tomography (SD OCT)–guided as-needed therapy with anti–vascular endothelial growth factor drugs. Methods: Patients with vascularized PEDs undergoing SD OCT–guided treatment with anti–vascular endothelial growth factor drugs were retrospectively identified. The decision to retreat these cases was based on qualitative assessments of fluid in the macula. Spectral domain OCT images from visits in which the treatment was withheld were retrospectively analyzed. A novel algorithm was then used to measure the area and volume of PEDs at these visits. Results: Fourteen eyes were identified, and retreatment was withheld at 57 visits. When the SD OCT algorithm was used to evaluate the scans from these visits, the PED volume increased at eight visits. At all of these eight visits, a treatment was needed at the next follow-up visit. For the remaining 49 visits in which the treatment was withheld, the PED volume did not increase and no treatment was needed at the next follow-up visit. Conclusion: Quantitation of the change in the PED volume and area may be useful in determining when to retreat eyes undergoing SD OCT–guided as-needed anti–vascular endothelial growth factor therapy. Using a novel spectral domain optical coherence tomography algorithm for the quantitation of vascularized retinal pigment epithelial detachments, the authors showed that an increase in the volume and area of pigment epithelial detachments in the absence of subretinal or intraretinal fluid may be a useful predictor for retreatment when followed patients undergoing anti–vascular endothelial growth factor therapy. © The Ophthalmic Communications Society, Inc.