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Pigment epithelial detachment size predictive of RPE tears after bevacizumab treatment
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Eyes with larger-sized pigment epithelial detachments have an increased risk of retinal pigment epithelial tears after treatment with bevacizumab for age-related macular degeneration, a study found.
Such tears are also more common in eyes with smaller choroidal neovascularization lesion sizes relative to the size of the pigment epithelial detachment (PED), the study authors noted.
Clement K. Chan, MD, and colleagues at centers in the United States and Europe investigated the incidence of retinal pigment epithelium (RPE) tears among patients treated with intravitreal Avastin (bevacizumab, Genentech) for neovascular AMD. The researchers focused on eyes with a vascularized PED that either did or did not develop an RPE tear, according to the study
Overall, surgeons performed 2,785 intravitreal bevacizumab injections in 1,064 eyes. Investigators found tears in 22 eyes of 22 patients (2.2%), which developed an average of 37.3 days post-injection. Also, 21 of the 22 eyes had a vascularized PED; 15 eyes had occult CNV and six had predominantly occult CNV, the authors reported.
Eyes that experienced tears had a larger subfoveal PED size, which averaged 13.97 mm² compared with 9.9 mm² for eyes without RPE tears (P = .01). Eyes with RPE tears also had a smaller ratio of CNV size to PED size, averaging 27.9% vs. 67.6% for eyes without such tears (P = .005), according to the study.
Best corrected visual acuity averaged 20/162 before injection and 20/160 after tears developed, the authors noted.
The study is published in the June issue of Retina.