title: Anatomical and visual outcomes of ranibizumab injections in retinal pigment epithelium tears.
abstract: OBJECTIVE
  To report the anatomical and visual results in patients diagnosed as having retinal pigment epithelium (RPE) tears after receiving ranibizumab injections.
  
  
  METHODS
  Eyes diagnosed as having RPE tears with a minimum 6-month follow-up were retrospectively evaluated. Each eye was treated with at least three doses of ranibizumab at monthly intervals. Best-corrected visual acuity (BCVA), anterior segment findings, intraocular pressure, and fundus examination results were evaluated during control visits. Color fundus photography, fundus fluorescein angiographies, fundus autofluorescence, and spectral domain optical coherence tomography (SD-OCT) images were obtained. The height of pigment epithelial detachment (PED) was measured by SD-OCT.
  
  
  RESULTS
  Twelve eyes with RPE tears were studied. Nine eyes (75%) developed RPE tears during ranibizumab injections for choroidal neovascularization (eight eyes with vascularized PED and one eye with choroidal osteoma), and tears occurred in three eyes before any injections. The median number of ranibizumab injections after diagnosis of RPE tears was 3 (min 2, max 5). In the most recent follow-up visit, there was no statistically significant correlation between the grade of RPE and logMAR of BCVA (p>0.05, r=0.112). Eight of twelve eyes had PED, and seven of these had irregular PED contours before injection therapy. The mean PED height was 447 ± 122 µm.
  
  
  CONCLUSIONS
  In this series, RPE tears developed mostly after intravitreal anti-VEGF injections for vascularized PED. Increased vertical height and irregular contours of the PEDs can be risk factors for the formation of RPE tears. The continuation of anti-VEGF therapy after tear formation is beneficial for vision improvement in eyes with RPE tears.
authors.affiliation: Ophthalmology Department, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Muhammet Kazım
authors.initials: MK
authors.lastname: Erol
authors.affiliation: Ophthalmology Department, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Ozdemir
authors.initials: O
authors.lastname: Ozdemir
authors.affiliation: Ophthalmology Department, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Deniz Turgut
authors.initials: DT
authors.lastname: Coban
authors.affiliation: Ophthalmology Department, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Basak Bostanci
authors.initials: BB
authors.lastname: Ceran
authors.affiliation: Ophthalmology Department, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey.
authors.forename: Esin Sogutlu
authors.initials: ES
authors.lastname: Sari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D020256:Choroidal Neovascularization / Q000188:drug therapy; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D058449:Intravitreal Injections / Q000379:methods; D008268:Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000008:administration & dosage* / Q000009:adverse effects; D012163:Retinal Detachment / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D055213:Retinal Pigment Epithelium / Q000187:drug effects* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D020533:Angiogenesis Inhibitors; D000069579:Ranibizumab