scholarly journals One year results of anti-VEGF treatment in pigment epithelial detachment secondary to macular degeneration

2013 ◽  
Vol 76 (4) ◽  
pp. 209-211 ◽  
Author(s):  
Harun Yüksel ◽  
Fatih M. Türkcü ◽  
Alparslan Şahin ◽  
Muhammed Şahin ◽  
Yasin Çinar ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Pigment Epithelial Detachment ◽  
Pigment Epithelial ◽  
Anti Vegf ◽  
One Year

scholarly journals Subthreshold Exudative Choroidal Neovascularization Associated With Age-Related Macular Degeneration Identified by Optical Coherence Tomography Angiography

2020 ◽  
Vol 4 (5) ◽  
pp. 377-385
Author(s):  
Miin Roh ◽  
Joan W. Miller ◽  
Karen W. Jeng-Miller ◽  
Jay C. Wang ◽  
Inês Laíns ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Degeneration ◽  
Choroidal Neovascularization ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Pigment Epithelial Detachment ◽  
Optical Coherence ◽  
Pigment Epithelial ◽  
Anti Vegf ◽  
Age Related

Purpose: This article describes the clinical and multimodal imaging characteristics of subthreshold exudative choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD). Methods: Among 3773 patients with AMD, 8 eyes (6 patients) were identified with the clinical phenotype of interest. Dilated fundus examinations, color fundus photography, fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and OCT angiography (OCTA) were performed. Results: OCT typically showed a moderately reflective irregular pigment epithelial detachment with overlying subretinal fluid (SRF). Traditional FA did not show leakage and ICGA showed no definitive neovascular network or hot spots. However, OCTA clearly demonstrated a CNV within the pigment epithelial detachment. The majority of our cases (7 of 8) did not receive antivascular endothelial growth factor (anti-VEGF) injections, and visual acuity remained stable over the available follow-up period of 1 to 10 years. Conclusions: CNV is often associated with SRF and vision loss in AMD, usually requiring frequent anti-VEGF injections. OCTA allowed us to better identify CNV not readily detected on FA and ICGA. Although some have suggested early clinical intervention with anti-VEGF injections in any case with fluid and confirmed CNV on OCTA, we describe a subset of AMD patients with SRF who may be better managed by observation. These cases may represent a more indolent, mature, and stable vascular network.

Formation of retinal pigment epithelium rupture in a patient with wet form of macular degeneration against the background of anti-vegf therapy

Reflection ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 67-72
Author(s):  
A.P. Yakimov ◽  
◽  
S.V. Kuzmin ◽  
◽  
Keyword(s):  
High Risk ◽  
Macular Degeneration ◽  
Clinical Case ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Pigment Epithelial Detachment ◽  
Case Methods ◽  
Pigment Epithelium Detachment ◽  
Pigment Epithelial ◽  
Anti Vegf

Purpose. To present possible complications of anti-VEGF therapy in patients with high pigment epithelial detachment on the basis of a clinical case. Methods. A clinical case of pigment epithelium rupture formation in a patient on the background of anti-VEGF therapy with aflibercept. Results. The presented clinical case clearly demonstrates the significance of OCT-signs of high risk of pigment epithelium rupture formation. The question of anti-VEGF therapy continuation in case of detection of these signs in a patient with continued activity of the process, as well as the choice of the drug, remains open. Key words: wet macular degeneration; pigment epithelium detachment; pigment epithelium rupture; aflibircept; ranibizumab.

scholarly journals Modern trends in diagnostics and prediction of results of anti-vascular endothelial growth factor therapy of pigment epithelial detachment in neovascular agerelated macular degeneration using deep machine learning method (literature review)

2021 ◽  
Vol 6 (6-1) ◽  
pp. 190-203
Author(s):  
E. V. Kozina ◽  
S. N. Sakhnov ◽  
V. V. Myasnikova ◽  
E. V. Bykova ◽  
L. E. Aksenova
Keyword(s):  
Machine Learning ◽  
Optical Coherence Tomography ◽  
Macular Degeneration ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Age Related Macular Degeneration ◽  
Pigment Epithelial Detachment ◽  
Optical Coherence ◽  
Pigment Epithelial ◽  
Anti Vegf

Detachment of the pigment epithelium is the separation of the basement membrane of the retinal pigment epithelium from the inner collagen layer of Bruch’s membrane, which occurs in 80 % of cases in patients with neovascular age-related macular degeneration. The outcome of anti-VEGF therapy for pigment epithelial detachment may be adherence of the pigment epithelium, the formation of pigment epithelium tear, or preservation of the detachment. The pigment epithelium tear of 3–4th degrees can lead to a sharp decrease in visual acuity.Most retrospective studies confi rm the absence of a proven correlation between anatomical and functional outcomes in the treatment of pigment epithelial detachment in cases of maintaining the integrity of the pigment epithelium monolayer, and therefore the main attention of researchers is focused on studying the morphological features of pigment epithelial detachment during therapy with angiogenesis inhibitors. Modern technologies of spectral optical coherence tomography make it possible to evaluate detailed quantitative parameters of pigment epithelium detachment, such as height, width, maximum linear diameter, area, volume and refl ectivity within the detachment.Groups of Russian and foreign authors identify various biomarkers recorded on optical coherence tomography images. Dynamic registration of such biomarkers expands the ability of clinicians to predict morphological changes in pigment epithelial detachment during anti-VEGF therapy, as well as to optimize treatment regimens to prevent complications in the form of pigment epithelium tear leading to a decrease in visual acuity.Modern methods of deep machine learning and the use of neural networks allow achieving higher accuracy in diff erentiating the types of retinal fluids and automating the quantitative determination of fl uid under the pigment epithelium. These technologies allow achieving a high level of compliance with manual expert assessment and increasing the accuracy and speed of predicting morphological results of treatment of pigment epithelium detachments.

scholarly journals Progression from Type 2 Macular Neovascularization to Fibrovascular Pigment Epithelial Detachment

Vision ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 16
Author(s):  
Hoang Mai LE ◽  
Gérard Mimoun ◽  
Salomon Y. Cohen ◽  
Camille Jung ◽  
Oudy Semoun ◽  
...  
Keyword(s):  
High Myopia ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Series Data ◽  
Pigment Epithelial Detachment ◽  
Angioid Streaks ◽  
Pigment Epithelial ◽  
Anti Vegf

The aim of this study was to report unusual progression of type 2 macular neovascularization (MNV) associated with age-related macular degeneration (AMD), high myopia or angioid streaks. Retrospective multicentric observational case series data were used. Eyes that progressed from type 2 MNV secondary to AMD, high myopia or angioid streaks to fibrovascular pigment epithelial detachment (PED) were included. A total of 29 treatment-naive eyes from 29 patients with type 2 MNV secondary to AMD (n = 14), high myopia (n = 10) or angioid streaks (n = 5) that progressed to a fibrovascular PED on Spectral Domain-Optical Coherence Tomography were used. This progression occurred within 3 months after anti-VEGF therapy initiation. Logarithm of minimum angle of resolution (LogMAR) visual acuity improved significantly after anti-VEGF therapy, from 0.55 (SD ± 0.30) (20/63–20/80) at baseline to 0.30 (20/40) at 3 months, and 0.33 (20/40) at the final follow-up (mean follow up: 3.68 years). Mean number of intravitreal injections per year for patients with a total follow-up ≥ 12 months (n = 24) was 4.3 ± 2.1 per year. Progression from type 2 MNV to a fibrovascular PED may occur in patients suffering from AMD, high myopia or angioid streaks. This progression appears early after initiation of anti-VEGF therapy and is associated with a favorable visual and anatomical outcome, at least on a short follow up basis.

scholarly journals De-novo multilayering in fibrovascular pigment epithelial detachment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manoj Soman ◽  
Jay U. Sheth ◽  
Asmita Indurkar ◽  
Padmanabhan Meleth ◽  
Unnikrishnan Nair
Keyword(s):  
De Novo ◽  
Median Number ◽  
Final Visit ◽  
Low Grade ◽  
Vascular Endothelial ◽  
Pigment Epithelial Detachment ◽  
Pigment Epithelial ◽  
Anti Vegf ◽  
Significant Difference ◽  
Endothelial Growth Factor

AbstractThis study describes the occurrence of multilayered pigment-epithelial detachment (MLPED) as a De-novo phenomenon (DN-MLPED) and compare the features with multi-layering secondary to chronic anti-vascular endothelial growth factor (anti-VEGF) therapy (s-MLPED). We did a retrospective evaluation of spectral-domain optical coherence tomography (SD-OCT) features, treatment-profile, and visual-acuity (VA) outcomes in eyes with MLPED. Out of 17 eyes with MLPED, 7 eyes had DN-MLPED and 10 eyes had s-MLPED. There was no significant difference in baseline and final VA between the groups. At the final visit, no significant visual improvement was noted in both the groups, although a possible trend towards an improvement was seen in DN-MLPED eyes while the s-MLPED demonstrated a declining trend (DN-MLPED—LogMAR-BCVA: Baseline = 0.79 [∼ 20/123] ± 0.91; Final = 0.76 [∼ 20/115] ± 0.73; p = 0.87; s-MLPED—LogMAR BCVA: Baseline = 0.43 [∼ 20/54] ± 0.68; Final = 0.94 [∼ 20/174] ± 0.71; p = 0.06). Moreover, after presentation, the median number of injections in DN-MLPED eyes were significantly lower compared to s-MLPED eyes (DN-MLPED:4; s-MLPED:12; p = 0.03) (Median follow-up: DN-MLPED = 26 months; s-MLPED = 54 months; p = 0.15). Subretinal hyperreflective-material (SHRM) deposition heralded the onset of multilayering and was seen to progress in all DN-PED eyes and 1/4 eyes of s-MLPED. To conclude, MLPED is a unique form of cicatrizing fibrovascular-PED which can evolve denovo too. Long-standing disease with intermittent or low-grade activity can potentially explain this unique phenomenon. With fewer anti-VEGF therapy, the de-novo MLPED eyes show more visual stability as compared to s-MLPED eyes.

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