Retinal pigment epithelial tear after photodynamic therapy for choroidal neovascularization

Gelişken, Faik; Inhoffen, Werner; Partsch, Michael; Schneider, Ulrike; Kreissig, Ingrid

doi:10.1016/s0002-9394(00)00813-8

Cited by 112 publications

(75 citation statements)

References 5 publications

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“…27,30,31 It has been shown that even with early laserphotocoagulation treatment or PDT, it is not possible to stabilize disease or slow down disease progression. 14,15,17,32 The reasons for these treatment failures were untreatable recurrences or the development of RPE tears.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13] Previously used therapeutic strategies such as photocoagulation or photodynamic therapy (PDT) have produced only unsatisfactory results. [13][14][15][16][17] The reasons for this include both the development of PED and CNV recurrences. Furthermore, treatment could no longer be carried out and thus the development of a central disciform scar could not be avoided.…”

Section: Introductionmentioning

confidence: 99%

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Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

Lommatzsch

Heimes

Gutfleisch

et al. 2009

Eye

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Aims To investigate the therapeutic effects of different treatments on serous pigment epithelium detachment (PED) in age-related macular degeneration (AMD). Methods A total of 328 patients suffering from serous PED in AMD were retrospectively analysed. We treated only patients with documented visual deterioration: 86 patients with bevacizumab, 128 with ranibizumab, 60 with pegaptanib, and 54 with photodynamic therapy (PDT) combined with intravitreal triamcinolone acetonide (IVTA). Bestcorrected vision was determined in the logarithm of the minimal angle of resolution (logMAR). We also analysed morphological findings such as full foveal thickness by optical coherence tomography (OCT), manually calculated height of PED as measured by OCT, and fluorescence angiography. Results The mean follow-up was 42.4 weeks. The best-corrected visual acuity of 0.78 logMAR before treatment could be improved by about 0.066 logMAR after treatment. Retinal thickness decreased in all patients with PED, in the mean by about 64.06 lm, and the mean value of the manually calculated height decreased by about 0.98 units. All functional and morphological results proved to be significantly better after injection of ranibizumab and bevacizumab than after pegaptanib and the combined treatment with PDT and IVTA. In all, 41 (12.5%) of our patients developed a tear of the retinal pigment epithelium (RPE). Conclusion The therapeutic results were significantly better in patients treated with bevacizumab and ranibizumab than in those treated with pegaptanib or with a combination of PDT and IVTA. Even with treatment, tears of the RPE or only a partial flattening of the PED always indicated a worse prognosis in eyes with exudative AMD than in eyes with classic choroidal neovascularization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

Lommatzsch

Heimes

Gutfleisch

et al. 2009

Eye

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“…Adverse events were rare in the 1,396 patients who received a total of several thousand intravitreal injections. Moreover, some adverse events are the result of the procedure (endophthalmitis, retinal detachment, cataract progression), others are mild (vitritis), or an event may also occur as a result of the natural course of AMD itself or with other therapies such as photodynamic therapy and ranibizumab [14,24]. Although the reported thromboembolic events could have been caused by bevacizumab, the time frame between injection and the event, the presence of additional risk factors, the age of the population, or the increased risk of cardiovascular diseases in patients with AMD make this less likely.…”

Section: Discussionmentioning

confidence: 99%

A systematic review on the effect of bevacizumab in exudative age-related macular degeneration

Schouten

Heij

Webers

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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Aim To provide evidence for the effect of bevacizumab on visual acuity (VA) and central retinal thickness (CRT) in exudative age-related macular degeneration Methods A systematic review of all articles of bevacizumab for exudative AMD was conducted. Articles published up to March 2008 were identified in Medline, Embase, the Cochrane Controlled Trials Register and references from included articles. Search terms were "Bevacizumab or Avastin" and "Macula* or ARMD or AMD or intra(-) vitreal or intra(-)vitreous". Three observers participated in the data retrieval and assignment of the quality scores. Results A total of 561 articles were retrieved. Three randomised controlled trials (RCT) and 23 before-and-after studies of patients (n=1,435) who had received bevacizumab were published. Inclusion criteria varied. Lack of masking was the main methodological shortcoming. These RCTs showed that bevacizumab is more effective than PDT. Bevacizumab was given intravenously or as intravitreal injection. The latter was given once, or repeatedly every 4 weeks, and with or without additional injection when a recurrence occurred, mostly based on visual acuity and/or findings from optical coherence tomography. After intravenous administration, the weighted mean change in VA was +12.8 ETDRS letters (range +11 to +14) and the weighted mean change for CRT was −129 μm (range −100 to −202). For the 23 studies with intravitreal injections, the change in VA was +8.6 letters (range +2 to +26) and the change in CRT was −90 μm (range −46 to −190). The incidence of adverse events was low. The change in VA was 2.7 letters higher for studies with a higher quality vs lower quality. Conclusion Visual acuity improves and central retinal thickness decreases in patients with exudative AMD after bevacizumab. There is no reasonable doubt that this is caused by bevacizumab. It is likely that a randomised controlled trial will show that bevacizumab is equivalent in effect to ranibizumab, which showed a change in ETDRS of +5.9 letters for occult or minimally classic CNV and +9.8 letters for classic CNV after three monthly injections in two large RCTs.

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“…may occur spontaneously, 2 after thermal laser treatment, 2 photodynamic therapy, 3 and intravitreal pegaptanib. 4 We describe a patient who had an RPE tear following intravitreal bevacizumab.…”

Section: 8mentioning

confidence: 99%

Retinal pigment epithelial tear following intravitreal bevacizumab

Bakri

Patel

2006

Eye

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Retinal pigment epithelial tear after photodynamic therapy for choroidal neovascularization

Cited by 112 publications

References 5 publications

Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

A systematic review on the effect of bevacizumab in exudative age-related macular degeneration

Retinal pigment epithelial tear following intravitreal bevacizumab

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