Pigment epithelial tears after ranibizumab injection in polypoidal choroidal vasculopathy and typical age-related macular degeneration.
OBJECTIVE
The purpose of the study was to compare the rates and characteristics of retinal pigment epithelial (RPE) tears between typical exudative age-related macular degeneration (tAMD) and polypoidal choroidal vasculopathy (PCV) after injection of intravitreal ranibizumab (IVR).


METHODS
In total, 836 eyes from 784 patients with exudative AMD treated with IVR were analyzed. The presence, type, size, and height of pigment epithelial detachment (PED) in OCT before injection were evaluated, and the occurrence rate of RPE tears within three months of injection between tAMD and PCV was compared.


RESULTS
In total, 515 eyes (61.6 %) had tAMD and 321 eyes (38.4 %) were diagnosed as PCV. RPE tears developed in 18 eyes (3.5 %) in the tAMD group, while only two eyes (0.62 %) were associated with PCV (p = 0.009, Chi-square test). Eleven of the eighteen eyes with RPE tears in tAMD had fibrovascular PED with contractile neovascular tissue under the surface of the RPE and a cleft at baseline. Two eyes with RPE tears in PCV showed large hemorrhagic PED before presenting with an RPE tear.


CONCLUSIONS
RPE tears after IVR were significantly less common in PCV than in tAMD. The different characteristics of RPE tears between the two disease entities suggest differences in the pathogenesis underlying the event.
The Institute of Vision Research, Severance Hospital, Department of Ophthalmology, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul, Korea, 120-752.
Joo Youn
JY
Shin
The Institute of Vision Research, Severance Hospital, Department of Ophthalmology, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul, Korea, 120-752.
Moonjung
M
Choi
The Institute of Vision Research, Severance Hospital, Department of Ophthalmology, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul, Korea, 120-752.
Byunghoon
B
Chung
The Institute of Vision Research, Severance Hospital, Department of Ophthalmology, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul, Korea, 120-752. shbyeon@yuhs.ac.
Suk Ho
SH
Byeon
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D011127:Polyps / Q000188:drug therapy*; D011183:Postoperative Complications; D000069579:Ranibizumab / Q000627:therapeutic use*; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology*; D055213:Retinal Pigment Epithelium / Q000293:injuries / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D057135:Wet Macular Degeneration / Q000188:drug therapy*
D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab
Age-related macular degeneration; Anti-vascular endothelial growth factor; Polypoidal choroidal vasculopathy; Ranibizumab; Retinal pigment epithelial tear