Prospective Evaluation of the Incidence and Risk Factors for the Development of Rpe Tears After High- And Low-Dose Ranibizumab Therapy

Abstract

In this study, the prospective incidence of RPE tears was ∼14%. A baseline PED height >550 microns and presence of a Grade 1 tear, or positive ring sign, were identified as high-risk factors for the subsequent development of an RPE tear.

Earlier therapeutic effects associated with high dose (2.0 mg) Ranibizumab for treatment of vascularized pigment epithelial detachments in age-related macular degeneration

“…Multiple reports have implicated the contribution of contractile forces of type-1 CNV under a PED to the mechanism of RPE tear development. [20][21][22][23][24][25][26] One spectral-domain OCT study showed that rapid and vigorous contraction of the neovascular tissue adherent to the undersurface of the RPE may impart a substantial contractile force for tearing the already-strained RPE. 27 Multiple reports have also documented retinal tears and detachment induced by contraction of fibrovascular tissues after anti-VEGF injections in eyes with proliferative diabetic retinopathy.…”

“…20 In that report, eyes with a maximum PED height4550 mm at baseline were associated with marked increased risk for RPE tears. 20 …”

“…There was no significant difference in the mean visual acuities between the two groups at baseline; however, the visual outcome was significantly worse for eyes that developed RPE tears at 12 months. 20 The details relating to the RPE tears in this study are described at length in a prior publication. 20 In that report, eyes with a maximum PED height4550 mm at baseline were associated with marked increased risk for RPE tears.…”

“…20 The details relating to the RPE tears in this study are described at length in a prior publication. 20 In that report, eyes with a maximum PED height4550 mm at baseline were associated with marked increased risk for RPE tears. 20 …”

Current Strategies for the Management of Treatment-Resistant Neovascular Age-Related Macular Degeneration

“…There were no significant ocular or systemic safety issues. Sarraf et al [19] found an increased risk for RPE tear in patients treated with 2.0 mg ranibizumab (10.8 %) compared with 0.5 mg (2.7 %), although these were cases with PED height, surface area, and greatest linear diameter significantly greater than those that did not develop RPE tears.…”