title: RETINAL PIGMENT EPITHELIAL ATROPHY AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS FOR RETINAL ANGIOMATOUS PROLIFERATION.
abstract: OBJECTIVE
  To investigate the incidence rate and risk factors for development of retinal pigment epithelial (RPE) atrophy during anti-vascular endothelial growth factor (anti-VEGF) treatment for retinal angiomatous proliferation.
  
  
  METHODS
  This study included 46 eyes with treatment-naive retinal angiomatous proliferation. All patients were treated with ranibizumab or aflibercept injections. Color fundus photography, spectral-domain optical coherence tomography, and fundus autofluorescence were evaluated for RPE atrophy diagnosis. Baseline characteristics and gene polymorphisms of ARMS2 A69S, and CFH I62V were analyzed for association with development and progression of RPE atrophy.
  
  
  RESULTS
  Among 21 eyes treated with ranibizumab without preexisting RPE atrophy at baseline, 5 eyes (23.8%) developed RPE atrophy at 12 months. Among 20 eyes treated with aflibercept without preexisting RPE atrophy at baseline, 10 eyes (50.0%) developed RPE atrophy at 12 months. Refractile drusen at baseline was associated with RPE atrophy development at 12 months (P = 0.014), and the progression rate of RPE atrophy area was negatively correlated with subfoveal choroidal thickness at baseline (R = -0.595, P = 0.019). Gene polymorphisms were not associated with RPE atrophy.
  
  
  CONCLUSIONS
  Retinal pigment epithelial atrophy developed in 36.6% during 12 months after anti-VEGF treatment for retinal angiomatous proliferation. The presence of refractile drusen at baseline was identified as a novel significant risk factor for RPE atrophy development.
authors.affiliation: *Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; and †Department of Ophthalmology, Faculty of Medicine, Kagawa University, Miki, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hata
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamashiro
authors.forename: Akio
authors.initials: A
authors.lastname: Oishi
authors.forename: Sotaro
authors.initials: S
authors.lastname: Ooto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.forename: Manabu
authors.initials: M
authors.lastname: Miyata
authors.forename: Naoko
authors.initials: N
authors.lastname: Ueda-Arakawa
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Ayako
authors.initials: A
authors.lastname: Takahashi
authors.forename: Akitaka
authors.initials: A
authors.lastname: Tsujikawa
authors.forename: Nagahisa
authors.initials: N
authors.lastname: Yoshimura
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D001284:Atrophy / Q000139:chemically induced / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D000069579:Ranibizumab / Q000008:administration & dosage / Q000009:adverse effects*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage / Q000037:antagonists & inhibitors; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000009:adverse effects*; D012162:Retinal Degeneration / Q000175:diagnosis / Q000188:drug therapy*; D055213:Retinal Pigment Epithelium / Q000187:drug effects / Q000473:pathology*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab