title: Retinal pigment epithelial tear after intravitreal aflibercept for neovascular age-related macular degeneration.
abstract: Two eyes with neovascular age-related macular degeneration and a suboptimal response to intravitreal ranibizumab and bevacizumab developed tears after being switched to intravitreal aflibercept, a drug with enhanced binding characteristics to vascular endothelial growth factor. Both eyes had sub-retinal pigment epithelium (RPE) choroidal neovascularization adherent to the back surface of the RPE in the fibrovascular RPE detachment that showed increased contracture of the fibrovascular tissue following the use of aflibercept. The driving force to develop the tears may be related to the recently described angiofibrotic switch, which is governed by the ration of connective tissue growth factor to vascular endothelial growth factor.
authors.forename: Taku
authors.initials: T
authors.lastname: Sato
authors.forename: Sotaro
authors.initials: S
authors.lastname: Ooto
authors.forename: Mihoko
authors.initials: M
authors.lastname: Suzuki
authors.forename: Richard F
authors.initials: RF
authors.lastname: Spaide
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D057915:Drug Substitution; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D040262:Receptors, Vascular Endothelial Growth Factor / Q000009:adverse effects* / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000009:adverse effects* / Q000627:therapeutic use; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology*; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D057135:Wet Macular Degeneration / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor