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Retinal pigment epithelial atrophy after anti-vascular endothelial growth factor therapy for polypoidal choroidal vasculopathy.
- Source :
-
The British journal of ophthalmology [Br J Ophthalmol] 2020 Oct; Vol. 104 (10), pp. 1443-1447. Date of Electronic Publication: 2020 Jan 02. - Publication Year :
- 2020
-
Abstract
- Background/aims: To describe the risk factors for the development of retinal pigment epithelial (RPE) atrophy following intravitreal anti-vascular endothelial growth factor (VEGF) injection treatment for polypoidal choroidal vasculopathy (PCV).<br />Methods: We retrospectively included 162 eyes of 162 treatment-naïve patients with PCV in this study. All patients were treated with an initial series of three monthly loading doses of anti-VEGF injections, followed by further injections as required. Baseline ocular characteristics and lesion features were assessed using fluorescein angiography, indocyanine green angiography and spectral domain optical coherence tomography, to determine and evaluate the potential risk factors for RPE atrophy through 2 years of follow-up.<br />Results: RPE atrophy had developed in 17 of 162 eyes (10.5%) after 2 years of anti-VEGF treatment. Nine cases (53.0%) of RPE atrophy occurred at branching vascular networks, and eight (47.0%) developed at locations with polyp or polyp-associated pigment epithelial detachment. Among the baseline characteristics, the mean subfoveal choroidal thickness was significantly thinner (192±98 vs 288±152; p=0.009) and presence of subretinal drusenoid deposits was significantly more frequent in eyes with RPE atrophy (11.8% vs 2.1%; p=0.028). Using multiple logistic regression analysis, the mean subfoveal choroidal thickness (OR 0.975; 95% CI 0.929 to 1.324; p=0.002) was identified as a significant risk factor for the development of RPE atrophy.<br />Conclusions: Approximately one-tenth of the patients with PCV developed RPE atrophy during the 24 months after intravitreal anti-VEGF injections. Subfoveal choroidal thinning at baseline is associated with increased risk of post-treatment RPE atrophy.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Aged
Aged, 80 and over
Angiogenesis Inhibitors therapeutic use
Atrophy
Coloring Agents administration & dosage
Drug-Related Side Effects and Adverse Reactions diagnosis
Female
Fluorescein Angiography
Follow-Up Studies
Humans
Indocyanine Green administration & dosage
Intravitreal Injections
Male
Middle Aged
Ranibizumab adverse effects
Ranibizumab therapeutic use
Receptors, Vascular Endothelial Growth Factor therapeutic use
Recombinant Fusion Proteins adverse effects
Recombinant Fusion Proteins therapeutic use
Retrospective Studies
Tomography, Optical Coherence
Angiogenesis Inhibitors adverse effects
Choroidal Neovascularization drug therapy
Drug-Related Side Effects and Adverse Reactions etiology
Polyps drug therapy
Retinal Pigment Epithelium pathology
Vascular Endothelial Growth Factor A antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2079
- Volume :
- 104
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The British journal of ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 31896542
- Full Text :
- https://doi.org/10.1136/bjophthalmol-2019-315496