Abstract

P 282

Preoperative OCT findings of pigment epithelial detachments with or without RPE-tears after bevacizumab injections

Carsten H. Meyer1, Clement Chan2, Prema Abraham3, Gregg Kokame4, Jeffrey Gross5, Peter Kaiser6
1Universitäts-Augenklinik Bonn, 2Southern California Desert Retina Consultants, Palm Springs, USA, 3Department of Ophthalmology, Loma Linda University, Loma Linda, USA, 4Retina Center at Pali Momi, Aiea, Hawaii, USA, 5Columbia, S. Carolina, Carolina Retina Center, USA, 6Cleveland Clinic, Cole Eye Institute, Cleveland, USA

Background
Pigment epithelial detachments (PED) due to neovascular age-related macular degeneration (nAMD) can develop RPE-tears after intravitreale injections of bevacizumab.
Methods
A retrospective multi-center study at 8 centers in the US and Europe examined 1280 eyes of 1255 patients, receiving 2890 intravitreal injections.  In 99 eyes with vascular PED (vPED), 21 eyes developed RPE tears (group 1) and 78 did not develop a RPE tear (group 2).  All eyes were examined by fluorescence angiography (FA) and Stratus OCT.  The height of the PED (Micron), PED surface (mm2), volume index, extent of the subretinalen liquid, total volume of the macula, thickness of the central retina, size of the choroidal neovascularization (CNV), relationship CNV/PED and best Snellen Visual acuity before and after the injection were raised.
Results
The height of the PED and the volume index (mm3) were significantly more increased in vPED eyes developing RPE tear compared to eyes with no RPE-tears (means: 648.9+/245.0 vs. 338,1 +-201,6 of Micron [P < 0.001]; Means: 9.3+/6.3 vs. 3.5+/4,0 mm3 [p < 0.001).  Also the surface of the PED differed significantly between eyes with RPE-tear and without (means: 13.7+/6.9 against 9.8+/7.5 mm2, p = 0.03).  Multivariate analysis showed PED height to be the only independent factor correlated with RPE-tear in vPED eyes (Odds ratio = 0.995  (95% CI: 0.992, 0.997), p <0.001.
Conclusion
Elevated RED height is the most reliable predictor for RPE-tears after bevacizumab injections for vPED eyes. 

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