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Retinal pigment epithelial tears following administration of intravitreal bevacizumab (3 case reports)
Author(s) -
KUOLIENE K,
CIMBALAS A,
AUKSTIKALNIENE M,
ASOKLIS R
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.424.x
Subject(s) - medicine , ophthalmology , bevacizumab , visual acuity , fundus (uterus) , tears , macular degeneration , fundus photography , choroidal neovascularization , fluorescein angiography , retinal , surgery , chemotherapy
Purpose To report three cases of retinal pigment epithelial (RPE) tears after repeated intravitreal injection of bevacizumab for the treatment of neovascular age‐related macular degeneration (AMD). To present fundus photography, fluorescein angiography (FA) and optical coherence tomography (OCT) findings. Methods Out of 433 patients treated with intravitreal bevacizumab injections for choroidal neovascularization, three patients with vascularized RPE detachment developed RPE tear. Case 1: the patient developed RPE tear shortly after the third intravitreal injection into the left eye; cases 2 and 3: the patients developed RPE tear after a single injection into the right eye and left eye, respectively. Visual acuity testing, fundus photography and OCT were performed for all patients monthly for over a year after the first injection. Results The preoperative size of the RPE detachment was 9.14 sq. mm for case 1, 5.16 sq. mm for case 2 and 5.93 sq. mm for case 3. At diagnosis of RPE tear, the patients suffered vision loss of three lines in cases 1 and 2 and two lines in case 3. After further treatment with bevacizumab, visual acuity at 12‐month follow‐up improved by two lines in case 1 and one line in cases 2 and 3. Conclusion 1. RPE tear can occur following treatment with intravitreal bevacizumab and is associated with significant visual loss. 2. Large RPE detachment may be a predictor for RPE tear. 3. Visual acuity improved in all three cases after further treatment with bevacizumab following RPE tear.