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Klin Monbl Augenheilkd 2014; 231(4): 432-435
DOI: 10.1055/s-0034-1368219
Klinische Studie
Georg Thieme Verlag KG Stuttgart · New York

Retinal Pigment Epithelium Rips After Ranibizumab in Neovascular Age-Related Macular Degeneration: Incidence, Risk Factors and Long-Term Outcome

Retinale Pigmentepithelrisse nach Ranibizumab bei der Behandlung der feuchten Makuladegeneration: Inzidenz, Risikofaktoren und Langzeitergebnisse
J. Guber
Sutton Eye Hospital, Epsom and St. Helier University Hospital (Lead Clinician: Miss Jane Leitch), London, UK
,
A. Praveen
Sutton Eye Hospital, Epsom and St. Helier University Hospital (Lead Clinician: Miss Jane Leitch), London, UK
,
M. U. Saeed
Sutton Eye Hospital, Epsom and St. Helier University Hospital (Lead Clinician: Miss Jane Leitch), London, UK
› Author Affiliations
Further Information

Publication History

received 09 September 2013

accepted 01 January 2014

Publication Date:
25 April 2014 (online)

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Abstract

Background: Retinal pigment epithelium (RPE) rips after ranibizumab for wet age related macular degeneration (AMD) with a pigment epithelial detachments (PED) are a dreaded complication. Aim of this study was to analyse the incidence, the risk factors and long-term outcome after a PED tear. Patients and Methods: 401 patients with wet AMD were analysed. A total of 33 eyes with PED were identified. Mean follow up time was 635 days (SD ± 311). Results: PED tears occurred in 8 (24 %) patients. Most RPE rips (40 %) occurred within the first three months. Mean visual loss was 13 letters (range − 57–9). The PED tear group had a mean PED height of 521 µm. The PED group without a tear had a mean height of 300 µm (p ≤ 0.001). Patients with a PED height over 300 µm had more than twice the risk to develop a RPE rip compared to patients with PED height smaller than 300 µm (p ≤ 0.001). Conclusions: PED height is a relevant factor for the incidence of RPE rips after treatment with ranibizumab. Owing to the close time relationship with the therapy, this complication must be taken into account before treatment as it may lead to significant vision loss.

Zusammenfassung

Hintergrund: Retinale Pigmentepithelrisse (RPE) nach Ranibizumab bei Patienten mit einer Pigmentepithelabhebung (PED) sind eine gefürchtete Komplikation. Ziel dieser Studie war es die Inzidenz, die Risikofaktoren für einen RPE-Riss sowie das Langzeitergebnis zu analysieren. Patienten und Methoden: Von 401 Patienten mit feuchter altersabhängiger Makuladegeneration wurden 33 Augen mit PED identifiziert. Die mittlere Nachbeobachtungszeit betrug 635 Tage. Ergebnisse: RPE-Risse traten bei 8 (24 %) Patienten auf. Die meisten RPE-Risse (40 %) ereigneten sich innerhalb der ersten 3 Monate. Der mittlere Sehverlust betrug 13 Buchstaben (range − 57–9). Patienten mit einem RPE-Riss hatten eine signifikant höhere PED-Höhe verglichen mit Patienten ohne Riss (p ≤ 0,001). Patienten mit einer PED über 300 µm hatten ein mehr als doppelt so hohes Risiko für einen RPE-Riss als Patienten mit einer PED kleiner als 300 µm (p ≤ 0,001). Schlussfolgerungen: Die PED-Höhe ist ein relevanter Faktor für das Auftreten eines RPE-Risses. Diese Komplikation muss vor Beginn der Behandlung berücksichtigt werden, da sie zu erheblichem Sehverlust führen kann.

Key words

age-related macular degeneration - retinal pigment epithelium rip - ranibizumab

Schlüsselwörter

altersabhängige Makuladegeneration - Pigmentepithelriss - Pigmentepithelabhebung - Ranibizumab
 

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