The effect of retinal pigment epithelial detachment on visual prognosis in patients with age related macular degeneration

Purpose: To assess the effect of pigment epithelial detachment (PED) on visual prognosis of patients with age related macular degeneration (ARMD) and to investigate the correlation between visual acuity (VA) and the parameters PED height, macular volume, foveal thickness.Material and Methods: The ARMD patients older than 55 years who were treated and followed from January 2009 to October 2011 in Ophthalmology Department of School of Medicine, Karadeniz Technical University, were enrolled in this study. The medical records of forty five eyes of thirty eight patiens with a diagnosis of exudative ARMD with PED (group I) and forty five eyes of thirty seven patients with a diagnosis of exudative ARMD without PED (group II) were prospectively analyzed. At baseline, at months 1, 3, 6 and 12, visual acuity (VA, logMAR), total macular volume (TMV) and central foveal thickness (CFT) measured by Stratus OCT were obtained and comparisons were made between the two groups. PED heights were measured manually. Correlations between the parameters VA and CFT, TMV, PED height were analysed statistically.Results: The mean VA at baseline was 1.2±0.7 logMAR in group I and 1.1±0.6 logMAR in group II and it was 1.2±0.7 logMAR in both of groups at month 12 . There was no statistically significant difference (p>0.05) in VA between the groups at all examinations. The mean macular volume was 8.02± 2.1mm3 at baseline and 7.25±1.39 mm3 at month 12 in group one and 7,06±1,17 mm3 at baseline and 7.08±1,4 mm3 at month 12 in group two. Only the difference in macular volume measured at baseline was statistically significant (p=0.014) between the groups. The mean central foveal thicknesses at baseline and month 12 were; 308 µm and 273 µm respectively in group I and 261µm ve 259 µm respectively in group II. The differences in mean central foveal thicknesses between the groups weren?t statistically significant (p>0.05) at baseline, months 1, 3, 6 and month 12. The mean PED height was 684 µm at baseline and 602 µm at 12 months. In group one, there weren?t statistitically significant differences (p>0.05) in parameters visual acuity, central foveal thickness and PED height between examinations . The difference in mean macular volüme between baseline and month 12 examinations was statistically significant (p=0.04) in group one. In group two, none of these parameters differed significantly (p>0.05) between examinations. There was statistically significant (p<0.05) correlation only between visual acuity and central foveal thickness (except month 12) in group one. There was a statistically significant (p=0.05 and p=0.03, respectively) correlation between PED height and visual acuity only at 6 month and 12 month after initiation of therapy. In group two, none of the parameters were significantly (p>0.05) corrrelate with visual acuity.Conclusions: It was determined that, uncomplicated PED did not effect negatively the visual prognosis in patients with exudative ARMD.Key Words: Age related macular degeneration, pigment epithelial detachment, visual acuity, total macular volüme, central foveal thickness