RESOLUTION OF A GIANT PIGMENT EPITHELIAL DETACHMENT WITH HALF-DOSE AFLIBERCEPT.

PURPOSE To describe the use of half-dose anti-vascular endothelial growth factor therapy in a patient with giant pigment epithelial detachments. METHODS Observational case report. A 76-year-old woman with neovascular age-related macular degeneration presented with massive bilateral pigment epithelial detachments measuring over 1000 μm in height. Her right eye was treated with standard-dose aflibercept, which led to two large retinal pigment epithelium tears. Treatment of the left eye with half-dose aflibercept led to complete resolution of the detachment without tear formation. RESULTS Half-dose anti-vascular endothelial growth factor therapy resulted in resolution of a giant pigment epithelial detachment ∼1500 μm in maximal height and 10 mm in diameter. CONCLUSION Reduced-dose anti-vascular endothelial growth factor therapy may be considered as a treatment option for very large pigment epithelial detachments at high risk for retinal pigment epithelium tear formation.

[1]  E. Rahimy,et al.  Retinal pigment epithelial tears in the era of intravitreal pharmacotherapy: risk factors, pathogenesis, prognosis and treatment (an American Ophthalmological Society thesis). , 2014, Transactions of the American Ophthalmological Society.

[2]  S. Ozdek,et al.  PIGMENT EPITHELIAL TEARS ASSOCIATED WITH ANTI-VEGF THERAPY: Incidence, Long-term Visual Outcome, and Relationship with Pigment Epithelial Detachment in Age-related Macular Degeneration , 2014, Retina.

[3]  M. Larsen,et al.  Mechanism of retinal pigment epithelium tear formation following intravitreal anti-vascular endothelial growth factor therapy revealed by spectral-domain optical coherence tomography. , 2013, American journal of ophthalmology.

[4]  P. Heiduschka,et al.  Prediction of retinal pigment epithelial tear in serous vascularized pigment epithelium detachment , 2012, Acta ophthalmologica.

[5]  R. Goldschmeding,et al.  A shift in the balance of vascular endothelial growth factor and connective tissue growth factor by bevacizumab causes the angiofibrotic switch in proliferative diabetic retinopathy , 2012, British Journal of Ophthalmology.

[6]  D. Sarraf,et al.  PREDICTORS OF Anti-VEGF-ASSOCIATED RETINAL PIGMENT EPITHELIAL TEAR USING FA AND OCT ANALYSIS , 2008, Retina.

[7]  Esther J. Kuiper,et al.  The Angio-Fibrotic Switch of VEGF and CTGF in Proliferative Diabetic Retinopathy , 2008, PloS one.

[8]  C. Flaxel,et al.  RPE TEARS AFTER PEGAPTANIB TREATMENT IN AGE-RELATED MACULAR DEGENERATION , 2007, Retina.

[9]  P. Kaiser,et al.  RETINAL PIGMENT EPITHELIAL TEARS AFTER INTRAVITREAL BEVACIZUMAB INJECTION FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION , 2007, Retina.

[10]  S. Garg,et al.  Retinal pigment epithelial tear after intravitreal bevacizumab injection. , 2006, American journal of ophthalmology.

[11]  R. Spaide,et al.  Retinal pigment epithelial tear after intravitreal aflibercept for neovascular age-related macular degeneration. , 2015, Ophthalmic surgery, lasers & imaging retina.