Additional anti-vascular endothelial growth factor therapy for eyes with a retinal pigment epithelial tear after the initial therapy.
OBJECTIVE
To evaluate the effects of additional anti-vascular endothelial growth factor (VEGF) therapy for eyes with a retinal pigment epithelial (RPE) tear after anti-VEGF therapy and treated with additional anti-VEGF injections for recurrent or persistent exudative change.


METHODS
Ten eyes (10 patients) followed up for >12 months after a recurrent RPE tear were evaluated retrospectively. The RPE tears on fundus autofluorescence images were measured and changes in the best-corrected visual acuity were evaluated.


RESULTS
Patients were followed up for >12 months (mean, 27.3; range, 13-44 months). During 12 months of follow-up, additional anti-VEGF injections (mean, 3.3; range, 1-7) were administered. The mean size of the RPE tear at the onset was 6.5 mm² (range, 1.3-16.3 mm²). At 12 months, the RPE tear increased in size >20% in 5 eyes and remained unchanged or decreased in the remaining half of eyes. The mean logarithm of the minimum angle of resolution best-corrected visual acuity was 0.43 at the time the RPE tear developed and 0.85 at 12 months. The RPE tear grade and age were prognostic factors for best-corrected visual acuity at 12 months.


CONCLUSIONS
Under continued anti-VEGF therapy, RPE tears may be stable in size and visual acuity could be maintained in some eyes; however, the visual acuity prognosis is still unsatisfactory in nonresponsive eyes.
*Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan; and †Department of Ophthalmology, Sumitomo Hospital, Osaka, Japan.
Kazunobu
K
Asao
Fumi
F
Gomi
Miki
M
Sawa
Kohji
K
Nishida
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D000069579:Ranibizumab; D012167:Retinal Perforations / Q000188:drug therapy* / Q000473:pathology; D055213:Retinal Pigment Epithelium / Q000293:injuries*; D019233:Retreatment; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab