Effects of VEGF inhibition on retinal morphology, neovascular network size, and visual acuity in patients with vascularized pigment epithelium detachment because of occult choroidal neovascularization

Retina. 2013 May;33(5):982-9. doi: 10.1097/IAE.0b013e31826d8ff4.

Abstract

Purpose: To report the results of vascular endothelial growth factor inhibition for vascularized pigment epithelium detachment associated with choroidal neovascularization secondary to age-related macular degeneration.

Methods: We performed a retrospective analysis of patients affected by vascularized pigment epithelium detachment treated with intravitreal anti-vascular endothelial growth factor (0.5 mg of ranibizumab or 1 mg of bevacizumab) and a follow-up of 12 months. Retinal angiomatous proliferations were excluded. Treatment was conducted with an initial loading phase followed by a pro re nata phase. Fluorescein angiography and indocyanine green angiography were performed at baseline and every 3 months.

Results: Forty eyes were included in this study. After a follow-up of 12 months and 5.5 treatments on average, best-corrected visual acuity did not vary significantly. Central retinal thickness and pigment epithelium detachment height were significantly reduced, whereas the choroidal neovascularization area remained constant.

Conclusion: In vascularized pigment epithelium detachment, anti-vascular endothelial growth factor therapy shows visual stabilization but not best-corrected visual acuity gain. However, it is associated with significant morphologic improvements, and it may offer a benefit over the natural course of the disease.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Bevacizumab
  • Choroidal Neovascularization / complications
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ranibizumab
  • Retinal Detachment / drug therapy*
  • Retinal Detachment / etiology
  • Retinal Detachment / physiopathology
  • Retrospective Studies
  • Vascular Endothelial Growth Factors / antagonists & inhibitors*
  • Visual Acuity / physiology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factors
  • Bevacizumab
  • Ranibizumab