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

摘要

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.