Prevalence of Age-Related Maculopathy

The Beaver Dam Eye Study was a population-based cohort study designed to collect information on the prevalence and incidence of age-related cataract, macular degeneration, and diabetic retinopathy. The results of the baseline examination for macular degeneration are reported in this chapter. One or more drusen were present in the macular area of at least one eye in 95% of the population. Signs of age-related maculopathy were common in people seventy-five years of age or older. Women of this age group had an incidence of exudative macular degeneration two to three times higher than their male counterparts. This study was an early indication that age-related macular degeneration was becoming a public health problem in an aging American population.

Retinal Pigment Epithelium Tear Following Aflibercept for Exudative Macular Degeneration Tachyphylactic to Anti-Vascular Endothelial Growth Factor A Agents

Purpose: To report two cases of retinal pigment epithelium (RPE) tears following treatment with aflibercept of exudative macula degeneration associated with pigment epithelial detachment (PED) tachyphylactic to antivascular endothelial growth factor (VEGF) A agents such as bevacizumab or ranibizumab.Methods: Retrospective case series of patients with exudative macular degeneration with PED who were managed with anti-VEGF A agents that developed RPE tear following the first aflibercept injection. The patients were followed with optical coherence tomography and fluorescein angiography.Results: In our two cases, RPE tear developed after being switched from bevacizumab or ranibizumab to treatment with aflibercept. Both cases were rescued with monthly ranibizumab injections. In each case vision and macular edema improved with continued treatment.Conclusion: RPE tears may occur following injection with aflibercept for treatment of exudative AMD tachyphylactic to bevacizumab or ranibizumab. Continued anti-VEGF treatment can be effective rescue therapy.