title: Long-term results of repeated anti-vascular endothelial growth factor therapy in eyes with retinal pigment epithelial tears.
abstract: OBJECTIVE
  To evaluate the long-term results of retinal pigment epithelium tears in eyes treated with repeated anti-vascular endothelial growth factor (VEGF) therapy.
  
  
  METHODS
  Five patients with retinal pigment epithelial tears (without foveal center involvement) after anti-VEGF injection were studied retrospectively. Mean follow-up time was 52 months, with measurements of visual acuity and evaluation of macular findings by angiography and optical coherence tomography during this period. All eyes had a persistent submacular neovascular membrane 30 days after the tear. An anti-VEGF drug was reinjected until the membranes stopped leaking.
  
  
  RESULTS
  The mean initial visual acuity immediately after the tear was 20/160, and the mean final visual acuity was 20/60. The number of anti-VEGF reinjections varied from two to eight during the follow-up period. Long-term optical coherence tomography analysis showed reduced fluid and remodeling of the torn retinal pigment epithelium.
  
  
  CONCLUSIONS
  Long-term visual results with repeated anti-VEGF therapy are not as devastating as suggested previously. Visual acuity and metamorphopsia improve with time as long as the neovascular membrane is inactive. Optical coherence tomography changes in the macular area reflect the visual acuity improvement.
authors.affiliation: Hospital de Olhos do Parana and Department of Ophthalmology, Universidade Federal do Parana, Curitiba, Brazil.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Moreira
authors.forename: Luis A
authors.initials: LA
authors.lastname: Arana
authors.forename: Rommel J
authors.initials: RJ
authors.lastname: Zago
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000068258:Bevacizumab; D002199:Capillary Permeability / Q000187:drug effects; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D015861:Retinal Neovascularization / Q000188:drug therapy* / Q000503:physiopathology; D012167:Retinal Perforations / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D019233:Retreatment; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab