Retinal Pigment Epithelium Tears Following Verteporfin Therapy Combined With Intravitreal Triamcinolone

Michels, Stephan; Aue, A.; Simader, Christian; Geitzenauer, W.; Sacu, Stefan; Schmidt‐Erfurth, Ursula

doi:10.1016/j.ajo.2005.08.046

Cited by 39 publications

(19 citation statements)

References 7 publications

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“…Same-day combination therapy could potentially limit the early exudative response after PDT, which may increase RPE tension and induce RPE tears [14]. In the present study, however, there were only two cases of RPE tears in the combination treatment group and no cases in the PDT group (Fig.…”

Section: Discussioncontrasting

confidence: 46%

Optical coherence tomography analysis of a randomized study combining photodynamic therapy with intravitreal triamcinolone

Arias

García-Arumí

Ramón.

et al. 2007

Graefes Arch Clin Exp Ophthalmol

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Section: Discussioncontrasting

confidence: 46%

Optical coherence tomography analysis of a randomized study combining photodynamic therapy with intravitreal triamcinolone

Arias

García-Arumí

Ramón.

et al. 2007

Graefes Arch Clin Exp Ophthalmol

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“…Tears of the retinal pigment epithelium (RPE), also named RPE rips, were described as a spontaneous complication of pigment epithelial detachments (PED) in the setting of wet AMD [6,7], and have also been described as a result of a variety of treatments [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22]. Such a lesion in one eye also involves high risk of a similar event occurring in the fellow eye [22].…”

Section: Introductionmentioning

confidence: 99%

Retinal Pigment Epithelium Tears in Age-Related Macular Degeneration Treated with Antiangiogenic Drugs: A Controlled Study with Long Follow-Up

Coco

Sanabria²,

Hernandez³

et al. 2012

Ophthalmologica

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Purpose: To study whether anti-vascular endothelial growth factor (VEGF) therapy improves visual acuity (VA) in patients with exudative age-related macular degeneration (AMD) complicated with retinal pigment epithelium (RPE) tears. Methods: Retrospective case-control series. Group I (control group) included 9 patients with RPE tears that received no treatment, and group II (intervention group) incorporated 12 patients treated with anti-VEGF. Results: A statistically significant difference was found in VA between the groups from the 3rd month to the final follow-up (p = 0.034). Final VA improved in the treatment group (p = 0.015). No differences were found in central macular thickness between the groups either before or after treatment. Mean number of injections in group II was 5.75 (SD = 1.19). Most patients presented a grade 3 rip. All lesions were inactive at the end of follow-up in group II and 1 remained active in group I. The number of final atrophic/disciform scars was 6/8 in group I and 7/5 in group II. Conclusions: RPE tears treated with antiangiogenic drugs experienced functional benefit. To the authors’ knowledge, this is the first controlled series reporting effectiveness of suppression of neovascular activity with antiangiogenic treatment after RPE rip in AMD.

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“…In most cases, the RPE tear is part of the natural history of pigment epithelial detachment (PED) that has developed as a result of occult choroidal neovascularization, retinal angiomatous proliferation, or polypoidal choroidal vasculopathy. [1][2][3] Such tears were first described as a spontaneous complication of PEDs in AMD by Hoskin et al 4 During followup, a RPE tear develops in B10% of eyes in which this type of exudative AMD has developed. 5 RPE tears also represent a complication that develops in association with various treatments for exudative AMD, such as laser photocoagulation, 6,7 transpupillary thermotherapy, 8 and photodynamic therapy (PDT).…”

Section: Introductionmentioning

confidence: 99%

Long-term visual outcome of pigment epithelial tears in association with anti-VEGF therapy of pigment epithelial detachment in AMD

Gutfleisch

Heimes

Schumacher

et al. 2011

Eye

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Purpose Retinal pigment epithelium (RPE) tears may develop as a complication after anti-VEGF (vascular endothelial growth factor) treatment for pigment epithelial detachments (PEDs) in exudative age-related macular degeneration (AMD). This retrospective study analyses best-corrected visual acuity (BCVA) and foveal involvement after RPE tears that are associated with anti-VEGF therapy due to PED in exudative AMD. Methods A total of 37 patients with RPE tears during anti-VEGF therapy (bevacizumab 12, ranibizumab 21 and pegaptanib 4 eyes) for progressive PED in AMD (PED with occult choroidal neovascularization 25 eyes and PED with retinal angiomatous proliferation 12 eyes) were included in this study. We analyzed BCVA and different morphologic aspects by means of appearance on fluorescein angiography and optical coherence tomography. Mean follow-up was 88 weeks. Results RPE tears were diagnosed a mean of 56 days after the first injection. BCVA deteriorated after RPE tear and during follow-up significantly (Po0.001), with 53.2% of eyes being legally blind (WHO, world health organization) at 12 months. RPE-free foveal area, foveal wrinkling of the RPE, and fibrotic scar development were significantly associated with worse visual acuity. Discussion RPE tears can be observed in 12-15% of treated eyes during anti-VEGF therapy for PED in exudative AMD. Owing to the close time relationship with the therapy, this complication must be taken into consideration. Visual prognosis is associated with a decrease in vision in the long term, often resulting in a severe visual disability. Relevant factors for a negative visual prognosis were the potential foveal involvement of the central RPE and morphologic fibrovascular transformation of the RPE tear.

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Retinal Pigment Epithelium Tears Following Verteporfin Therapy Combined With Intravitreal Triamcinolone

Cited by 39 publications

References 7 publications

Optical coherence tomography analysis of a randomized study combining photodynamic therapy with intravitreal triamcinolone

Optical coherence tomography analysis of a randomized study combining photodynamic therapy with intravitreal triamcinolone

Retinal Pigment Epithelium Tears in Age-Related Macular Degeneration Treated with Antiangiogenic Drugs: A Controlled Study with Long Follow-Up

Long-term visual outcome of pigment epithelial tears in association with anti-VEGF therapy of pigment epithelial detachment in AMD

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