title: Imaging characteristics of neovascular pigment epithelial detachments and their response to anti-vascular endothelial growth factor therapy.
abstract: OBJECTIVE
  To evaluate the imaging characteristics of macular neovascular pigment epithelial detachments (PEDs) and their response to anti-vascular endothelial growth factor (VEGF) therapy.
  
  
  METHODS
  Patients with exudative age-related macular degeneration (AMD), idiopathic polypoidal choroidal vasculopathy, presumed ocular histoplasmosis syndrome (POHS) and central serous retinopathy (CSR) with choroidal neovascularisation (CNV) were included in the study. A retrospective chart review of 72 eyes of 64 patients was performed.
  
  
  RESULTS
  Three types of PEDs were identified based on reflectivity of the material under the retinal pigment epithelium on optical coherence tomography: hollow (26 eyes with primarily hyporeflectivity under the PED), solid (30 eyes with primarily hyperreflective signal under the PED) and mixed (8 eyes with mixed reflectivity). The average number of anti-VEGF injections was 7 per eye and the average duration of follow-up was 16 months. Among eyes with exudative AMD, 7/21 hollow PEDs flattened, 1/19 solid PEDs flattened and 2/6 mixed PEDs flattened after anti-VEGF therapy. POHS and CSR with CNV were associated with subfoveal solid PEDs and were unchanged after therapy. Overall, 46% (12/26) with hollow PEDs, 25% (2/8) with mixed PEDs and 3% (1/30) with solid PEDs had flattening after anti-VEGF therapy.
  
  
  CONCLUSIONS
  The likelihood of PED flattening was inversely related to the reflectivity of the PED. The more reflective the PED, the less likely resolution with anti-VEGF therapy occurred.
authors.affiliation: Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611, USA.
authors.forename: Omar S
authors.initials: OS
authors.lastname: Punjabi
authors.forename: Joyce
authors.initials: J
authors.lastname: Huang
authors.forename: Lina
authors.initials: L
authors.lastname: Rodriguez
authors.forename: Alice T
authors.initials: AT
authors.lastname: Lyon
authors.forename: Lee M
authors.initials: LM
authors.lastname: Jampol
authors.forename: Rukhsana G
authors.initials: RG
authors.lastname: Mirza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000188:drug therapy*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012163:Retinal Detachment / Q000175:diagnosis* / Q000188:drug therapy*; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy; D055213:Retinal Pigment Epithelium / Q000187:drug effects / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D007208:Indocyanine Green; D000069579:Ranibizumab
keywords: Imaging; Macula; Retina