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Effekt von Bevacizumab auf die Abhebung des retinalen Pigmentepithels bei okkulter choroidaler Neovaskularisation

Effect of intravitreal bevacizumab on pigment epithelial detachment in occult choroidal neovascularization

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Zusammenfassung

Hintergrund

Ziel war die Beurteilung des Effekts von intravitrealem Bevacizumab auf die Abhebung des retinalen Pigmentepithels (PED) durch okkulte choroidale Neovaskularisation (CNV) bei altersabhängiger Makuladegeneration (AMD). Prädiktive Faktoren für das therapeutische Ansprechen wurden analysiert.

Methoden

Untersucht wurden 73 Augen mit PED und zusätzlich vorhandener intra- und/oder subretinale Flüssigkeit (IRF/SRF). Therapiert wurde mit 1,25 mg Bevacizumab intravitreal. Reinjektionen erfolgten entsprechend dem Vorhandensein von IRF/SRF in 6- bis 8-wöchigen Abständen.

Ergebnisse

53,4% der Augen zeigten eine Reduktion der PED-Höhe. Eine Höhenabnahme korrelierte nicht mit einem Visusanstieg. Der mittlere Visus stieg von 0,53±0,29 logMAR auf 0,49±0,32 logMAR (p=0,170), die mittlere PED-Höhe nahm von 354,4±196,2 μm auf 277,4±199 μm ab (p=0,004). Prädiktive Faktoren waren eine hohe PED-Ausgangshöhe und ein Dezimalvisus schlechter als 0,32.

Schlussfolgerung

In etwa der Hälfte der Augen kam es zu einer Abflachung der PED infolge der Bevacizumab-Therapie, insbesondere in Augen mit schlechtem Ausgangsvisus und ausgeprägten Abhebungen des retinalen Pigmentepithels. Der Visus kann durch Bevacizumab stabilisiert werden, eine Abflachung des PED ist aber nicht mit einem Visusanstieg korreliert.

Abstract

Purpose

This study aimed to investigate the effect of bevacizumab on pigment epithelial detachment (PED) in occult choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD) and to determine predictive factors.

Methods

73 eyes of patients with AMD and PED due to CNV with subretinal and/or intraretinal fluid were assessed. Patients were treated with 1.25 mg of intravitreal bevacizumab.

Results

After 30.6 weeks, the mean visual acuity (VA) increased from 0.53 to 0.49 logMAR (p=0.170). The mean PED height decreased from 354.4 μm to 277.4 μm (p=0.004). Although 53.4% of the eyes showed a reduction in PED, this did not correlate with a significant change in VA. Predictive factors were a high baseline PED and VA <0.32.

Conclusion

Half of the patients showed PED flattening. Especially in patients with distinctive PED, a response to intravitreal bevacizumab may be expected. This therapy can stabilize VA, but PED flattening does not essentially correlate with an increase in VA.

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Literatur

  1. The Moorfields Macular Study Group (1982) Retinal pigment epithelial detachments in the elderly: a controlled trial of argon laser photocoagulation. Br J Ophthalmol 66:1–16

    Article  Google Scholar 

  2. Algvere PV, Steen B, Seregard S, Kvanta A (2008) A prospective study on intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration of different durations. Acta Ophthalmol 86:482–489

    Article  CAS  PubMed  Google Scholar 

  3. Casswell AG, Kohen D, Bird AC (1985) Retinal pigment epithelial detachments in the elderly: classification and outcome. Br J Ophthalmol 69:397–403

    Article  CAS  PubMed  Google Scholar 

  4. Chang LK, Flaxel CJ, Lauer AK, Sarraf D (2007) RPE tears after pegaptanib treatment in age-related macular degeneration. Retina 27:857–863

    Article  PubMed  Google Scholar 

  5. Chen CY, Wong TY, Heriot WJ (2007) Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration: a short-term study. Am J Ophthalmol 143:510–512

    Article  CAS  PubMed  Google Scholar 

  6. Costa RA, Jorge R, Calucci D et al (2006) Intravitreal bevacizumab for choroidal neovascularization caused by AMD (IBeNA Study): results of a phase 1 dose-escalation study. Invest Ophthalmol Vis Sci 47:4569–4578

    Article  PubMed  Google Scholar 

  7. Frimpong-Boateng A, Varde MA, Rufer F et al (2008) Intravitreal administration of triamcinolone and bevacizumab for pigment epithelial detachment in conjunction with AMD. Ophthalmologe 105:661–668

    Article  CAS  PubMed  Google Scholar 

  8. Fung AE, Rosenfeld PJ, Reichel E (2006) The international intravitreal bevacizumab safety survey: using the internet to assess drug safety worldwide. Br J Ophthalmol 90:1344–1349

    Article  CAS  PubMed  Google Scholar 

  9. Kashani AH, Keane PA, Dustin L et al (2009) Quantitative subanalysis of cystoid spaces and outer nuclear layer using optical coherence tomography in age-related macular degeneration. Invest Ophthalmol Vis Sci 50:3366–3373

    Article  PubMed  Google Scholar 

  10. Meyer CH, Mennel S, Schmidt JC, Kroll P (2006) Acute retinal pigment epithelial tear following intravitreal bevacizumab (Avastin) injection for occult choroidal neovascularisation secondary to age related macular degeneration. Br J Ophthalmol 90:1207–1208

    Article  CAS  PubMed  Google Scholar 

  11. Pauleikhoff D, Loffert D, Spital G et al (2002) Pigment epithelial detachment in the elderly. Clinical differentiation, natural course and pathogenetic implications. Graefes Arch Clin Exp Ophthalmol 240:533–538

    Article  CAS  PubMed  Google Scholar 

  12. Pedersen KB, Sjolie AK, Moller F (2008) Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration in treatment-naive patients. Acta Ophthalmol

  13. Rich RM, Rosenfeld PJ, Puliafito CA et al (2006) Short-term safety and efficacy of intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration. Retina 26:495–511

    Article  PubMed  Google Scholar 

  14. Singh RP, Sears JE (2006) Retinal pigment epithelial tears after pegaptanib injection for exudative age-related macular degeneration. Am J Ophthalmol 142:160–162

    Article  CAS  PubMed  Google Scholar 

  15. Spaide RF, Laud K, Fine HF et al (2006) Intravitreal bevacizumab treatment of choroidal neovascularization secondary to age-related macular degeneration. Retina 26:383–390

    Article  PubMed  Google Scholar 

  16. Wu L, Martinez-Castellanos MA, Quiroz-Mercado H et al (2008) Twelve-month safety of intravitreal injections of bevacizumab (Avastin): results of the Pan-American Collaborative Retina Study Group (PACORES). Graefes Arch Clin Exp Ophthalmol 246:81–87

    Article  CAS  PubMed  Google Scholar 

  17. Yoganathan P, Deramo VA, Lai JC et al (2006) Visual improvement following intravitreal bevacizumab (Avastin) in exudative age-related macular degeneration. Retina 26:994–998

    Article  PubMed  Google Scholar 

  18. Zayit-Soudry S, Moroz I, Loewenstein A (2007) Retinal pigment epithelial detachment. Surv Ophthalmol 52:227–243

    Article  PubMed  Google Scholar 

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  1. Universitäts-Augenklinik, Im Neuneheimer Feld 400, Heidelberg, Deutschland

    M. Ruppenstein, T. Ach, A. Höh &  S. Dithmar

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  1. M. Ruppenstein
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  2. T. Ach
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  3. A. Höh
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  4. S. Dithmar
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Correspondence to S. Dithmar.

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Ruppenstein, M., Ach, T., Höh, A. et al. Effekt von Bevacizumab auf die Abhebung des retinalen Pigmentepithels bei okkulter choroidaler Neovaskularisation. Ophthalmologe 107, 827–830 (2010). https://doi.org/10.1007/s00347-010-2166-z

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  • DOI: https://doi.org/10.1007/s00347-010-2166-z

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