title: BRIDGE ARCH-SHAPED SEROUS RETINAL DETACHMENT IN AGE-RELATED MACULAR DEGENERATION.
abstract: OBJECTIVE
  To describe bridge arch-shaped serous retinal detachment (SRD) in exudative age-related macular degeneration and evaluate its functional outcomes.
  
  
  METHODS
  In this monocentric, retrospective, noncomparative case series, patients were included. Patients with exudative age-related macular degeneration and bridge arch-shaped SRD treated with ranibizumab were included. Anatomical patterns of SRD and functional outcomes were assessed.
  
  
  RESULTS
  Twenty-two eyes with bridge arch-shaped SRD of 22 patients with age-related macular degeneration were included. Serous retinal detachments were characterized by a steep angle at the junction between the retinal pigment epithelium and the sensory retina (mean, 53.45 ± 12.5°), and characterized by the presence of adhesion areas between the sensory retina and a fibrous complex developed from the choroidal neovascularization. In 15 eyes, the choroidal neovascularization was classic choroidal neovascularization and a fibrotic evolution was observed. Serous retinal detachments were compartmentalized in 14 eyes, leading to a multipocket structure. Visual acuity decreased from 49.9 ± 19.2 letters (20/100) to 40.3 ± 18.6 letters (20/160), corresponding to a mean change of -9.6 ± 19.4 letters.
  
  
  CONCLUSIONS
  This was the first study to describe the specific morphologic features of bridge arch-shaped SRD, a previously undescribed type of SRD complicating exudative age-related macular degeneration. Patients with bridge arch-shaped SRD responded to intravitreal injections of ranibizumab, but their visual prognosis was unfavorable, compared with the literature. The presence of bridge arch-shaped SRD seemed to be a marker for the fibrotic evolution of the choroidal neovascularization.
authors.affiliation: *Centre Ophtalmologique d'Imagerie et de Laser, Paris, France; †Department of Ophthalmology, Hôpital Avicenne, Assistance Publique, Hôpitaux de Paris, and Paris 13 University, Bobigny, France; and ‡Department of Ophthalmology, Hôpital intercommunal de Créteil, and Paris-Est-Creteil University, Créteil, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Fajnkuchen
authors.forename: Salomon Y
authors.initials: SY
authors.lastname: Cohen
authors.forename: Nathalie
authors.initials: N
authors.lastname: Thay
authors.forename: Sandrine
authors.initials: S
authors.lastname: Ayrault
authors.forename: Corinne
authors.initials: C
authors.lastname: Delahaye-Mazza
authors.forename: Typhaine
authors.initials: T
authors.lastname: Grenet
authors.forename: Sylvia
authors.initials: S
authors.lastname: Nghiem-Buffet
authors.forename: Gabriel
authors.initials: G
authors.lastname: Quentel
authors.forename: Audrey
authors.initials: A
authors.lastname: Giocanti-Auregan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D000069579:Ranibizumab / Q000627:therapeutic use; D012163:Retinal Detachment / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab