Abstract

SA.16.06

Effect of intravitreal bevacizumab on pigment epithelium detachment in occult CNV

Mira Ruppenstein, Thomas Ach, Alexandra Eva Höh, Stefan Dithmar
Universitäts-Augenklinik Heidelberg

Objective
To assess the therapeutic effects of intravitreal bevacizumab on pigment epithelium detachment (PED) in occult choroidal neovascularization (CNV) due to age related macular degeneration (AMD).
Methods
In 71 eyes with PED and concomitant sub- or intraretinal fluid (IRF) in occult CNV, 1.25 mg bevacizumab was injected. Baseline and follow up visits (6-8 weeks) included best corrected visual acuity (VA), complete ophthalmological examination and a Stratus-OCT. Reinjections were performed at persisting IRF, increase of PED or decrease of visual acuity (> 1 line). Changes in high and volume of PED were analyzed by a computer-assisted software.
Results
71 eyes of 67 patients (22 male, 45 female, 75.8 ± 6.4 years old) received 3 ± 1.8 injections during 39.4 ± 26.6 weeks. At last visit, patients showed a reduction of PED high (303 ± 183 µm vs. 260 ± 185 µm; p=0,055) and volume (750 ± 673 µl vs. 710 ± 730 µl; p=0,66) of the PED, while VA  remaind stable (0.53 ± 0.28 logMAR vs. 0.54 ± 0.45 logMAR; p=0,864). 54 % presented a reduction of PED height at last visit (group 1), in 46% high was stable or increased (group 2). Compared to group 2, group 1 showed a significant worse VA (0.60 ± 0.26 logMAR vs. 0.44 ± 0.26 logMAR; p=0.008), significant higher PED (356 ± 180 µm vs. 241 ± 170 µm; p=0.003) and a significant bigger volume (911 ± 683 µl vs. 564 ± 621 µl; p=0.003). In both groups there was no significant change in visual acuity (group 1: p=0.135; group2: p=0.836) an no correlation to in-/decrease of PED hight (0.94, p=0.434)
Four eyes (5.6%) showed a complete flattening of PED.
Conclusions
In this retrospective analysis, half of patients presented a PED flattening. Especially in patients with distinctive PED a response due to intravitreal bevacizumab may be expected. Intravitreal bevacizumab can stabilize VA, but flattening of PED is not essentially correlated with an increase of visual acuity.

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