Article
SD-OCT documentation of changes in pigment epithelial detachment after intravitreal ranibizumab therapy: six-month results of a prospective randomized study
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Published: | June 15, 2011 |
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Purpose: To report the effect of intravitreal injections of ranibizumab on various features of pigment epithelial detachment (PED).
Methods: 15 patients with PED associated with AMD received injections of 0.5 mg ranibizumab monthly. All subjects underwent a standardized ophthalmic evaluation monthly, consisting of visual acuity (VA) measurement using ETDRS charts, and imaging with optical coherence tomography evaluating changes in thickness of PED. Fluorescein angiography (FA) was performed at baseline and every 3 months afterwards.
Results: Mean central PED thickness decreased from 624.7 (±350.8 microns) at baseline to 332.5 (±158 microns) at the 6-month follow up (P=0.005). Mean ETDRS VA remained stable from 56.1 (±14.6) letters score at baseline to 58.6 (±15.7) letters score at the 6-month follow up (P=0.64). Subretinal fluid (SRF) disappeared in 8 patients (53.3%), 6 eyes (40%) showed a decreased in SRF and 1 eye developed an increase of SRF. In 11 eyes, OCT showed hyperreflective mass and optically clear space underneath the retinal pigment epithelium. The hyperreflective mass correlates with the border irregularity and inhomogeneous hyperfluorescence, whereas the optically clear space presents a homogeneous pooling. For 10 patients a complete regression of the optically clear space occurred after 6 injections. The hyperreflective mass flattened and in consequence a distinct decrease of hyperfluorescence within the FLA had been noted.
Conclusions: By means of SD-OCT and FLA, different reaction of the tissue after injection of ranibizumab were detected, which could only partly be attributed to preoperative PED characteristics. The prognostic relevance of these features is currently being evaluated further.